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^ 


HOSPITALS, 

BRITISH,  FRENCH,  AND  AMERICAN, 

TO   WHICH  IS  APPENDED 

A  GLANCE  AT   THE 
BRITISH  ISLANDS,  FRANCE,  AND    AMERICA, 

Ethnological,  Climatic,  and  General. 


EDWIN    R.  MAXSON,  M.D., 

Author  of  Practice  of  Mediciue,  &c. 


PHILADELPritA:' 
PUBLISHED   FOR   THE  AUTHQR, 

1868.  —---■- 


Entered  according  to  Act  of  Congre*?,  in  the  year  1868,  by 

Edwin  R.  Maxson,  M.D., 
In  the  Clerk's  OflBce  of  the  District  Court  for  the  Eastern  Dis- 
trict of  Pennsylvania, 


Biomedics 


lOO 


CONTENTS, 


PART  FIRST 


HOSPITALS. 

BRITISH,  FRENCH,  AND  AMERICAN. 

PAGE. 

Introduction  to  Part  1 9 

GREENOCK  HOSPITALS t 10 

Greenock  Infirmary 10 

GLASGOW  HOSPITALS .,  11 

lloyal  Infirmary , 12 

Glasgow  Eye  Infirmary 14 

Dispensary  for  tkiu  Diseases IG 

EDINBURGH  HOSPITALS 18 

Koyal  Infirmary *, 18 

Chalmer's  Hospital 22 

LONDON  HOSPITALS 26 

Guy's  Hospital 26 

King's  College  Hospital 29 

University  College  Hospital 31 

Westminster  Hospital 32 

St.  Bartholomew's  Hospital 34 

National  Hospital  for  Epileptics  and  Paralytics 36 

Children's  Hospital 38 

The  London  Hospital 39 

LIVERPOOL  HOSPITALS 42 

Royal  Infirmary 42 

DUBLIN  HOSPITALS 43 

Mercer's  Hospital 44 

Sir  Patrick  Dun's  Hospital 45 

Ilardwicke  Hospital 45 

Richmond  District  Lunatic  Asylum 46 

Dublin  Lying-in  Hospital , 51 

St.  Mark's  Ophthalmic  HospitsJ 51 

FRENCH  OR  PARISIAN  HOSPITALS 53 

Hotel  Dieu. 04 

LariboiHiero.  Hosiiital f>4 

LaCtiarile  Hoypital 55 

Beaojon  Hospital 56 


695637 


4  CONTENTS. 

PAGE. 

La  Pitie  IlOfipital 57 

Hospital  of  Invslid  Soldiers 58 

AMERICAN  HOSPITALS 61 

Buffalo  Hospital 62 

Utica  Lunatic  Asylum 62 

Montreal  and  Quebec  Hospitals 63 

New  York  and  Brooklyn  Hospitals 64 

Philadelphia  Hospitals 64 

CONCLUSION 66 


PART    SECOND. 

A  Glance  at  the  British  Islands,  France  and 

America. 

Ethnological,  Cumatic,  and  Geneeal. 

PAGE. 

Introduction  to  Part  II 71 

SCOTLAND  AND  THE  SCOTCH 73 

Chief  Towns— Glatigow ». .'....."...  76 

Edinburgh 78 

The  Scotch  People 81 

ENGLAND  AND  THE  ENGLISH 82 

Chief  Towns — London '..."  85 

Liverpool 89 

The  English  People 91 

WALES  AND   THE  WELSH. 94 

Chief  Towns— Holyhead 96 

The  Welsh  People 96 

IRELAND  AND  THE  IRISH 98 

Chief  Towns— Dublin 101 

The  Irish  People 102 

FRA.NCE  AND  THE  FRENCH 107 

Chief  Towns— Paris 110 

The  French  IVople 113 

Sovereigns  of  France  and  Great  Britain „.  116 

AMERICA  AND  AMERICANS 117 

Chief  Towns '.'.',  us 

New  York,  Philadelphia,  &c 119 

The  American  People 119 

American  Goverument  and  Civilization 120 

CONCLUSION 121 


PREFACE. 


Having  "been  engaged  in  my  professional  pur- 
suits for  nearly  twenty-five  years,  with  an  exten- 
sive practice,  I  could  not  do  less  than  make 
general  observations  in  relation  to  disease,  its 
etiology,  pathology,  treatment,  &c.  And  from  a 
careful  record  of  the  causes  of  the  various  diseases 
that  have  fallen  under  my  observation  and  care, 
I  long  since  became  impressed  with  the  vital 
importance  of  Hygiene,  private  and  public,  as  a 
means  of  preventing,  and  thereby  eradicating, 
disease. 

Becoming  thus  fully  convinced  that  very  much 
might  and  should  be  done,  in  that  direction,  to 
lessen  the  burden  of  common  misery,  by  tluis 
improving  the  liuman  race  physically,  and  there- 
I)y  intellectually  and  morally,  I  attempted  to 
hold  up,  in  my  Practice  of  Medicine,  the  impor- 
tance of  kygkaic  principLts,  venturing  to  predict, 


6  PREFACE. 

"that  more  light  on  this  subject,  and  a  more 
careful  observation  of  the  causes  of  disease'^ 
would  yet  "bring  home  to  us  the  unpleasant  fact 
that  the  imprudences  of  mankind  in  deviating 
from  the  laws  of  Health,  produce  the  predisposi- 
tion to  epidemics,  as  well  as  all  other  diseases," 
&c.,  and  I  am  only  surprised  to  find  my  predic- 
tions becoming  so  rapidly  fulfilled,  in  the  recent 
discoveries  in  relation  to  the  causes  of  cholera 
and  other  diseases. 

In  this  general  sketch  of  my  recent  observa- 
tions, at  home  and  abroad,  I  have  attempted  to 
elucidate  still  further  the  importance  of  personal 
and  public  hygiene,  as  well  as  the  principles 
of  rational,  medical,  surgical,  and  obstetrical 
science  and  practice;  and,  also,  by  showing  our 
relations^  to  illustrate  more  clearly  the  brother- 
hood of  man,  the  recognition  of  which  is  neces- 
sarily involved  in  the  light  of  dawning  modern 
Christian  civilization;  and  also  calculated  to  aid 
in  the  elevation  of  the  standard  of  physical, 
intellectual,  and  moral  excellence.  It  may  be 
noticed  that  I  have  invariably  used  the  first 
person  singular,  in  sjieaking,  myself,  instead  of 
the  plural.     This  I   do  because   I   know  of  no 


PREEACE.  7 

authority  or  reason  for  such  an  assumption, 
except^  in  the  case  of  Kings  and  Queens.  I 
believe  that  Shakespeare  seldom  or  never  uses 
tho  plural  for  one  person,  except  vrhen  Sover- 
eigns speak.  Let  it  not,  then,  be  regarded  as 
arrogance,  but  the  opposite,  as  it  really  is,  in 
truth.  With  this  explanation  I  submit  the  little 
book,  with  my  regards,  to  all  who  may  give  it  a 
reading;  and  especially  to  those  at  home  and 
abroad,  through  whose  kindness  I  have  been 
enabled  to  write  it,  with  all  its  imperfections. 
Edwin  R.  Maxson. 

No.  1844  Camac  St.,  Philadelphia,  May,  1868. 


ERRATA. 

Reverse  the  points  of  compass,  on  page  43,  in  lines  3,  4,  6,  and 
9  from  bottom.  Also,  on  page  40,  sixth  line  from  bottom,  for 
never  read  ever.  And  on  the  25th  page,  14th  line  from  bottom, 
for  are  read  is. 


HOSPITALS. 

BRITISH,  FRENCH,  AND   AMERICAN. 
Part  I. 


Having  been  abroad  in  Europe  during  the 
summer  of  1867,  for  medical  observation;  and 
having  visited  and  attended  the  hospitals  of 
Greenock,  Grlasgow,  Edinburgh,  London,  Liver- 
pool, Dublin,  and  Paris,  for  longer  or  shorter 
periods;  and  having  previously,  and  since  my 
return,  visited  the  hospitals  of  Buffalo,  Utica, 
Montreal,  Quebec,  New  York,  Brooklyn,  and 
Philadelphia,  I  propose  to  speak  descriptiveli/ 
and  somewhat  critically^  of  the  hospitals  of 
Greenock,  Glasgow,  Edinburgh,  London,  Li- 
verpool, Dublin,  and  Paris,  separately,  and  in 
the  order  in  which  I  have  named  them,  con- 
cluding with  some  general  remarks  in  relation 
to  the  American  hospitals  above  named ;  hop- 
ing to  draw  some  conclusions  that  may  be  of 
interest,  so  far  as  hospitals  are  concerned; 
and,  if  possible,  to  elucidate  a  few  medical, 
2  (0) 


10 

surgical,  and  obstetrical,  as  well  as  hygienic 
principles. 

And  while  I  shall  purposely  avoid  all  minu- 
tij^e  of  detail,  I  hope  to  he  able  to  give  such 
general  and  practical  observations  in  relation 
to  the  hospitals  above  named,  abroad  and  at 
home,  as  may  be  of  general  interest  to  physi- 
cians and  students.  And  in  doing  this  I  shall 
necessarily  refer  to  some  of  the  physicians 
and  surgeons  in  attendance,  as  well  as  to  the 
prevailing  diseases  4n  each,  etc.  And  farther, 
as  I  wrote  from  abroad*  most  of  that  which  I 
d'scovered  that  was  specially  neiUj  I  shall  pur- 
posely avoid  so  much  as  was  thus  written  and 
published,  in  order  not  to  repeat,  and  thus 
weary  the  patience  of  any. 

First,  then, 

Greenock  Hospital. 

The  Greenock  Infirmary  is  pleasantly  situa- 
ted in  the  very  considerable  town  of  Green- 
ock, on  the  river  Clyde,  in  Scotland,  about 
twenty  miles  below  Glasgow.  The  hospital 
has,  I  believe,  from  one  to  two  hundred  beds, 
and   is  very  well    arranged   and    conducted. 

*  In  a  series  of  letters  to  the  P.Iedical  axd  Sukgical 
Reporter,  in  lS6r. 


11 

And  ttougli  on  a  side-hill,  making  the  surface 
drainage  excellent,  the  whole  town  is  very 
damp  and  well  calculated  to  develope  tjphus 
fever,  bronchial  and  rheumatic  affections, 
which  are  the  prevailing  diseases  in  the  hos- 
pital, together  with  the  usual  variety  of  sur- 
gical cases,  etc. 

The  resident  and  visiting  physicians,  Drs. 
Campbell  and  Fox,  are  gentlemen,  who  not 
only  treated  me  very  politely,  but  appeared  to 
exercise  a  kind  supervisioi.  over  the  patients 
under  their  care;  their  medical  and  surgical 
treatment  being,  though  conservative,  as  ap- 
peared to  me,  very  judicious.  That  which 
struck  me  most  forcibly  in  this  hospital,  it 
being  the  first  I  was  in  abroad,  was  the  ample 
supply  of  nourishment,  including  milk,  broths, 
egg,  toast,  etc.,  allowed  the  patients;  en- 
tirely in  accordance  with  my  own  notions  in 
relation  to  the  nourishment  of  patients,  so  ear- 
nestly recommended  by  me  in  this  country,  in 
my  Lectures,  Practice  of  Medicine,  and  pri- 
vate practice. 

Glasgow  Hospitals. 

The  hospitals  of  Glasgow  that  I  shall  men- 
tion are,  the  Eojal  Infirmary;  the  Glasgow 


12 

Eye  Infirmary,  having  accommodations  for 
boarders  as  well  as  out-patients ;  and  the  Dis- 
pensary for  Diseases  of  the  Skin,  of  Dr.  Mc- 
Call  Anderson;  and  in  the  order  in  which 
I  have  named  them. 

Royal  Infirmary. 

The  Koyal  Infirmary  of  Glasgow,  contain- 
ing accommodations  for  four  or  five  hundred 
patients,  is  very  well  situated  on  a  rise  of 
ground  in  the  ancient  part  of  the  city,  near  the 
old  University  and  the  Cathedral  of  the  twelfth 
century.  It  is  substantially  built  and  very 
well  arranged,  having  all  the  necessary  appur- 
tenances for  a  first-class  hospital;  including 
lecture  rooms,  instruments,  etc. 

It  has  an  excellent  corps  of  nurses,  able 
residents,  and  eminent  visiting  physicians, 
including  Drs.  Leishman,  GtArdner,  Bucha- 
nan, MacLeod,  and  Watson,  and  others  I 
need  not  mention ;  men  doing  as  much  for  the 
advancement  of  medical,  surgical,  and  obstet- 
rical science,  in  my  opinion,  as  any  in  the 
British  Islands.  With  one  eye  impartially 
turned  to  American  improvements,  and  the 
other  intent  upon  their  numerous  and  instruc- 
tive cases,  glancing  occasionally  across  to  the 


1  o 
lo 

Continent,  they  sliow  themselves   worthy  of 
the  high  position  they  occupy. 

The  diseases  that  come  under  their  observa- 
tion, are  the  usual  variety,  including  medical 
and  surgical  cases;  and  among  the  former, 
typhus  fever  may  be  regarded  as  predominat- 
ing, though  pulmonary,  rheumatic,  and  almost 
every  form  of  disease  common  to  our  climate 
may  be  found  there.  Inflammatory  affections, 
however,  including  pneumonia,  pleurisy,  etc., 
are  generally  of  a  more  passive  or  asthenic 
character  than  with  us  in  America.  And  I 
must  say,  that  the  surgical  cases,  or  such  of 
them  as  were  the  result  of  contused,  lace- 
rated, and  incised  wounds,  compound  frac- 
tures, etc.,  under  the  general  supervision  of 
Prof.  Lister,  with  the  carbolic  acid  applica- 
tions, were  really  apparently  doing  better, 
and  making  more  rapid  recoveries  than  any 
similar  cases  I  have  seen  anywhere,  in  hos- 
pitals or  private  practice.  And,  it  appeared 
to  me,  that  the  antiseptic  effect  of  the  car- 
bolic acid  thus  used  upon  these  cases,  affect- 
ing the  atmosphere  of  the  wards,  v/as  not  lost 
upon  all  the  patients  in  those  wards;  and,  in 
fact,  in  the  entire  hospital,  so  far  as  its  influ- 
ence was  extended  by  evaporation,  being  con- 
2* 


14 

ducted  by  the  air,  giving  a  decided  tendency 
to  resolution  in  all  local,  and  even  a  more  rapid 
convalescence  in  most  general  affections,  med- 
ical as  well  as  surgical.  And  it  may  not  be 
improper  for  me  to  state  here,  that  I  was  not 
alone  in  this  observation  and  conclusion. 

Glasgow  Eye  Infirmary. 

This  excellent  infirmary,  situated  near  the 
Clyde,  in  the  eastern  part  of  Glasgow,  con- 
ducted by  Drs.  McKenzie  and  Kainey,  his 
partner,  affords  accommodations  for  boarders, 
and  perhaps  from  thirty  to  fifty  out-patients 
may  be  prescribed  for  daily,  judging  from 
what  I  saw;  Dr.  Rainey  having  the  principal 
charge;  Dr.  McKenzie  being  advised  with  in 
bad  cases,  but  on  account  of  his  age,  generally 
at  his  residence,  I  believe. 

While  at  this  excellent  infirmary  every  va- 
riety of  disease  of  the  eye  is  prescribed  for 
and  treated  in  the  most  rational  and  judicious 
manner,  scrofulous  o^phthalmia  appeared  to 
predominate.  And  I  was  pleased  to  find  that 
everything  possible  was  done  by  way  of  cloth- 
ing, food,  etc.,  that  could  be  made  to  act  re- 
med'ally;  and  then  cod-liver  oil,  iron,  etc., 
used  internally;  the  local  applications,  if  used, 


15 

being  generally  of  a  soothing  character,  as 
atropia,  two  grains  to  the  ounce  of  water,  or 
wine  of  opium,  applied  to  the  inverted  upper  lid, 
by  a  camel's-hair  brush,  as  most  convenient. 

While,  however,  such  cases  receive  this 
general  conservative  treatment,  iritis  is  met 
by  cathartics,  leeches,  calomel,  belladonna, 
iodide  of  potassium,  warm  sitz-baths,  etc.; 
catarrhal  ophthalmia^  by  cupping,  leeching, 
the  sitz-baths,  and  the  solution  of  atropia, 
two  grains  to  the  ounce  of  water,  locally,  with 
the  brush ;  ulceration  of  the  cornea^  by  cathar- 
tics, leeches,  blisters,  and  the  application  of  a 
solution  of  nitrate  of  silver,  ten  grains  to  the 
ounce  of  water;  and  rheumatic  ophthalmia^ 
by  iodide  of  potassium  and  the  solution  of 
atropia,  or  wine  of  opium  to  the  eye,  as  in  the 
other  aflfections  ;  while  the  operation  for  cata- 
ract  is  by  extraction j  it  being  regarded  as  su- 
perior to  that  by  depression,  as  sometimes 
practiced  in  other  places.  And,  for  Dr. 
George  Rainey,  the  efficient  manager  of 
this  excellent  infirmary,  with  the  advice  of  his 
venerable  partner.  Dr.  McKenzie,  I  predict 
a  brilliant  future,  should  his  life  and  health 
be  spared.  A  more  perfect  gentleman  I  never 
met.     lie  is,  also,  an  accomplished  scholar. 


IC 

Diqjonsary  for  Shin  Diseases^. 

Dr.  McCall  Anderson's  Dispensary  for 
Diseases  of  the  Skhi,  with  a  convenient  build- 
iog,  in  a  central  part  of  tlie  Old  Town,  with 
lecture,  reception,  waiting-rooms,  etc.,  is  one 
of  the  real  beneficiaries  of  Glasgow;  being 
admirably  conducted,  and  aflfording  an  excel- 
lent opportunity  for  the  students  of  the  two 
medical  universities,  to  become  thoroughly 
acquainted  with  skin  diseases,  and  their  treat- 
ment. 

Dr.  Andernon  is  Lecturer  on  the  Practice 
of  Medicine,  in  Anderson's  University;  has 
published  a  valuable  work  on  eczema;  and 
treats  in  the  most  rational  and  common  sense 
manner,  the  large  number  of  cases  that  resort 
to  his  dispensary  for  relief;  including  every 
variety  of  skin  disease;  among  which,  the 
papular,  vesicular,  and  pustular  eruptions, 
classed  by  the  Dr.  with  erythema,  as  eczema- 
tous,  may  be  the  most  common.  JScahfes^ 
however,  and  the  other  aoimalcular,  as  well 
as  scalj/  and  cryptogamous  eruptions,  etc.,  are 
by  no  means  infrequent. 

Without  going  into  detail,  I  will  only  add, 
that  the  first  inquiry  of  the  Dr.,  is  to  ascer- 
tain  the   character   of  the   disease,   and    its 


17 

cauae.  Then,  like  a  rational  common  sense 
man,  after  removing  the  cause,  as  far  as  pos- 
sible, he  strives  to  correct  the  deranged  con- 
dition of  the  system,  upon  which  the  local 
disease  may  depend,  when  such  general  de- 
rangements exist ;  after  which,  such  stimu- 
lating, soothing,  antiseptic,  cleansing,  or  other 
remedies,  as  may  be  indicated,  are  applied, 
thus  making,  as  appeared  to  me,  all  his  pre- 
scriptions strictly  rational.  It  is  not  strange, 
that  under  such  a  rational,  judicious  course  of 
treatment,  his  patients  should  so  very  gener- 
ally rapidly  recover.  Very  much  is  accom- 
plished by  ablutions,  proper  food,  clothing, 
etc.  Internalli/,  as  alteratives  and  tonics;  ar- 
senic, mercury,  syrup  of  iodide  of  iron,  cod- 
liver  oil,  etc.,  are  mainly  relied  upon ;  while 
externalli/j  oxide  of  zinc,  carbolic  acid,  potassa, 
sulphur,  cod-liver  oil,  etc.,  are  often  used, 
when  clearly  indicated.  The  Doctor  is  yet  a 
comparatively  young  man;  and,  having  a 
good  constitution,  and  a  thorough  education, 
is  doubtless  destined  to  falfil  his  mission,  as 
a  physician,  with  great  credit  to  himself,  and 
honor  to  our  cob^e  profession.  In  fact,  there 
are  few  men,  at  home  or  abroad,  in  whose  inti- 
mate friendship,  I  feel  a  more  lively  satisfaction. 


18 


Edinburgh  IIost'Itals. 
The  Hoyal  Infirmary  and  Ciialmer's  Hos- 
pital of  Edinburgh,  are  worthy  of  a  passing 
general  notice;  in  pait  from  the  extent  of  the 
one,  and  the  neatness  and  fine  situation  of 
the  other;  and  also,  on  account  of  the  high 
standing  of  the  physicians  and  surgeons  in  at- 
tendance there.  They  are  also  of  extraordina- 
ry interest^  on  account  of  the  illustrious  names 
that  have  been  associated  with  them  in  the  past. 

Royal  Infirmary. 

The  Royal  Infirmary  of  Edinburgh,  has 
I  believe,  accommodations  for  nearly  five 
hundred  patients,  being  quite  well  situat- 
ed, near  the  University  in  the  Old  Town,  a 
little  east  of  the  ancient  street  leading  from 
the  old  Parliament  House  to  Holyrood  Palace, 
on  which,  a  little  to  the  west  of  the  infirmary, 
is  John  Knox's  house. 

It  is  a  substantial  stone  structure,  tolerably 
well  arranged;  having  ample  lecture  rooms; 
and  most  of  the  conveniences  of  modern  hos- 
pitals, of  such  capacity;  and  some  comforts 
in  its  arrangements,  unknown  to  many  of  them. 
Its  nurses  are  attentive;  the  residents  gentle- 
manly; and  I  need  not  say,  that  the  viciting 


19 

physicians  aad  surgeons  are  among  the  most 
able  that  grace  the  wards  of  any  hospital,  any- 
where ;  of  whom  I  may  name  Professors  Syme, 
Bennett,  Layoock,  Simpson,  Duncan, 
Watson,  etc.,  as  the  most  prominent. 

Almost  every  variety  of  disease  may  be 
found  here,  common  to  the  climate.  And, 
though  typhus  fever  may  perhaps  be  less  pre- 
dominant than  at  Greenock  or  Glasgow,  I 
think  it  must  be  admitted,  that  all,  even  in- 
flammatory diseases,  including  pleuritis  and 
pneumonia,  are  of  an  asthenic  or  passive  char- 
acter, with  perhaps  very  few  exceptions; 
none  of  the  inflammatory  affections,  however, 
appearing  to  me  to  be  of  that  active  sthenic 
character,  sometimes  met  with  even  in  our 
hospitals  in  this  country. 

Scrofula  and  tuhercular  phthisis  may  be  re- 
garded as  quite  prevalent;  though  the  former 
perhaps  less  so  than  at  Glasgow;  and  of  sur- 
gical cases  they  have  about  the  usual  variety. 
It  may  also  be  proper  to  state,  that  tj/phoid 
fever,  though  not  very  prevalent,  may  be 
found  to  a  limited  extent. 

Carbolic  acid  is  used  here,  as  in  the  Royal 
Infirmary  of  Glasgow;  and  fractures  of  the 
femur    are    treated    by    Dr.    Swinburne's 


20 

method,  extension  being  made  by  the  pulley 
and  weight.  It  is  called,  in  Edinburgh,  the 
^^  American  metJiod;"  and  the  results  have 
been,  as  I  was  informed,  more  satisfactory 
than  by  any  other.  Surgical  cases,  generally, 
appeared  to  me  to  be  very  judiciously  treated ; 
Professor  Syme  and  Dr.  Watson  appearing  to 
have  a  lively  interest  for  the  comfort,  safety, 
and  permanent  welfare  of  their  patients. 

Scrofula^  tubercular  j^^^/wszs,  and  other 
kindred  diseases,  are  treated  by  good  food, 
cod-liver  oil,  iodine,  iron,  etc.,  and  as  appeared 
to  me,  very  judiciously;  the  laryngoscope 
being  resorted  to,  as  a  means  of  diagnosis,  in 
laryngeal  complications,  or  primary  affections. 

Tophus  fever  is  treated,  mainly,  and  it  ap- 
peared to  me,  too  exclusively,  by  milk,  beef- 
tea,  eggs,  etc.  For,  though  the  good  nourish- 
ment is  clearly  indicated,  in  all  the  cases, 
it  appeared  to  me  that  other  valuable  reme- 
dies might  often  have  been  made  available 
in  fulfilling  indications,  had  not  the  all-suffi- 
ciency of  the  nourishment  alone,  been  so  ex- 
clusively relied  upon.  In  fact,  I  believe  that 
many  of  the  cases  might  have  been  arrested, 
or  very  much  cut  short,  by  the  use,  in  adui- 
dition,  of  quinine  or  fluid  extract  of  bark. 


21 

Pneumonia  and  pleurittSj  as  they  occur  ia 
the  Kojal  Infirmary  of  Edinburgh,  being  gen- 
erally of  a  decidedly  low,  passive,  or  asthenic 
character,  as  I  have  already  stated,  may  very 
generally  require  the  tonic  and  even  stimulat- 
ing course  of  treatment,  adopted,  and  so 
strongly  recommended  by  Professor  Bennett  j 
and  especially  the  pneumonia.  In  fact,  I  do 
not  remember  to  have  seen  a  case  there,  that 
I  would  not  have  treated  with  tonics,  stimu- 
lants, and  good  nourishment.  Though  cases, 
I  believe,  sometimes  occur,  in  which  even  Dr. 
Bennett  discovers  indications  for  slightly 
lowering  or  depressing  treatment;  and  I  have 
no  doubt  but  that  pleuritis  may  quite  often 
require  local  depletion;  and  possibly,  in  some 
cases,  general;  and,  were  the  local  more  gen- 
erally resorted  to,  in  pleuritis,  in  connection 
with  the  tonics,  stimulants,  and  good  diet,  it  is 
my  opinion  fewer  cases  of  hydrothorax  would 
follow.     But  perhaps  not. 

Professor  Bennett  is  a  close  observer; 
never,  I  think,  administering  a  remedy  with- 
out a  clear  indication.  He  has  done,  and  is 
still  doing  very  much,  by  his  close  observa- 
tions, and  the  exercise  of  his  master  mind,  to 
do  away  with  the  unnecessary,  irrational,  and 
3 


22 

worse  ttan  superfluous  administration  of  medi- 
cines, when  not  clearly  indicated;  and  in  sub- 
stituting a  more  rational  treatment  of  disease,  < 
as  it  has  fallen  under  his  observation. 

I  cannot  leave  this  venerable  old  infirmary, 
without  saying  what  I  am  compelled  to;  that 
the  physicians  and  surgeons  that  now  grace  its 
wards,  including  Professors  Syme,  Bennett, 
Simpson,  Watson,  Laycock,  and  Duncan, 
besides  being  an  honor  to  the  positions  they 
occupy,  professionally,  are  gentlemen,  in  every 
sense  of  the  word.  And  to  Professors  Syme, 
Bennett,  Simpson,  and  Watson,  especially, 
I  am  under  great  obligations;  and  am  happy 
in  being  able  to  regard  them  as  among  my 
most  cherished  friends. 

Chalmer's  Hospital. 

Chalmer's  Rospitaly  situated  in  the  south- 
eastern new  portion  of  Edinburgh,  is  on  a 
smaller  scale,  accommodating,  perhaps,  be- 
tween one  and  two  hundred  patients.  It  has 
a  beautiful  green  field  or  park  in  its  rear;  and 
is  well  situated  and  arranged  for  such  a 
beneficent  purpose,  though  somewhat  more 
private  in  its  character  than  the  Koyal  Infir- 
mary. 

I  was  introduced  there   by  Dr.  Watson, 


23 

who  appeared  to  Have  the  general  supervision, 
being,  as  appeared,  Visiting  Physician  and 
Surgeon,  as  well  as  one  of  the  Surgeons  to  the 
Royal  Infirmary,  and  withal  a  most  accom- 
plished gentleman,  in  every  sense  of  the  word. 
The  Resident,  also,  though  evidently  not 
often  interrupted  by  visitors,  showed  me  every 
possible  politeness,  and  cordially  invited  me  to 
spend  as  much  time  there  as  I  could  afford  to. 

Under  such  direct  and  general  supervision, 
with  such  a  situation  and  surroundings,  it  is 
not  strange  that  very  great  success  should 
attend  the  cases,  medical  and  surgical;  and 
such  I  believe  to  be  the  case;  their  patients 
being  cleanly,  well  fed,  and  evidently  receiv- 
ing judicious  treatment,  in  every  respect. 

Chloroform  is  used,  as  I  noticed,  as  well  as 
carholic  acid.  Dr.  Watson,  in  removing  a 
loose  or  movable  cartilage  from  the  knee-joint, 
as  I  noticed,  first  dipping  his  forceps  and 
bistoury  in  a  mixture  of  equal  parts  of  car- 
bolic acid  and  linseed  oil;  and  after  its  re- 
moval, and  closing  the  cut  by  metalic  sutures, 
without  washing  off  the  blood,  applied  a 
cloth  wet  with  the  same  mixture,  and  then 
over  this  a  paste  made  of  one  part  of  the 
carbolic  acid  to  four  of  the  oil,  mixed  with 


21 

sufiBcicnt  prepared  cLalk  to  make  it  spread 
on  block-tin,  as  used  by  Prof.  Lister,  at 
Glasgow,  and  at  the  Royal  Infirmary  of  Edin- 
burgh, by  Watson  and  Syme. 

Dr.  Swinburne's  method  of  extension  by 
the  pulley  and  weight,  is  in  use  at  this  Hospital, 
as  well  as  at  the  Royal  Infirmary;  and  Dr.  Wat- 
son assured  me  that  he  got,  beyond  all  com- 
parison, the  best  results  from  it,  in  fractures  of 
the  thigh.  I  noticed  in  the  use  of  chloroform, 
at  Chalmer's  Hospital,  as  well  as  at  the  Royal 
Infirmary,  that  it  was  administered  from  a 
folded  cloth,  thus  allowing  the  patient  a  full 
supply  of  air ;  a  precaution  which  they  claim 
has  saved  them  from  fatal  results  in  its  admin- 
istration; and  I  am  confident  that  it  is  by  far 
more  safe  thus  administered,  than  by  a  napkin, 
in  the  form  of  a  hollow  cone,  fitting  over  the 
nose,  as  I  have  sometimes  witnessed. 

Finally,  in  closing  this  very  general  ac- 
count of  my  observations  in  the  Hospitals  cf 
Scotland,  I  will  only  add,  that  the  Scotch 
physicians  and  surgeons  are  not  afraid  to 
acknowledge  and  adopt  American  improve- 
ments, when  discovered  to  be  such.  This 
fact,  together  with  their  close  observation  of 
disease,  in  all  its  forms,  and  the  hints  they 


25 

receive  from  tlie  Continent  of  Europe,  to 
which  they  are  ever  alive,  has  enabled  them  to 
make  great  advancements  in  medical,  surgical, 
and  obstetrical  science.  And  I  was  most 
happy  to  find  that  my  own  views  in  relation 
to  nourishing  patients,  so  freely  announced  in 
my  Practice  of  Medicine  and  Lectures,  in 
this  country,  are  fully  sustained,  not  only  the 
principles,  but  also  the  particulars;  milk 
standing  first  on  the  list,  as  I  have  always 
contended;  eggs,  toast,  etc.,  during  conva- 
lescence. And  it  may  be  proper  to  state,  in 
conclusion,  that  to  Professors  Bennett,  of 
Edinburgh,  and  Gardner,  of  Glasgow,  are 
mainly  due  the  credit  of  establishing,  not 
only  in  Scotland,  but  throughout  the  British 
Islands,  the  long  undiscovered  fact,  that  the 
sick  should  not  be  allowed  to  starve,  any  more 
than  the  well.  I  may  be  allowed,  also,  to 
state,  that  Sir  James  Simpson  highly  ap- 
proved of  my  method  of  changiog  shoukkr 
into  natural  presentations,  by  the  position  of 
Prof.  Thomas,  for  reducing  prolapsed  cord, 
with  slight  manipulation,  saying,  that  I  was 
ahead  of  them  all  in  this,  though  he  had 
himself  thought  of  something  similar;  stoutly 
condemning  external  manipulations  to  change 
3-^ 


26 

abnormal  presentations,  on  account  of  the 
danger  of  detaching  the  placenta,  and  causing 
fatal  hemorrhage,  should  the  cord  be  around 
the  neck  of  the  child,  as  is  often  the  case; 
and  I  may  add,  that  Prof.  Thomas's  method 
of  replacing  prolapsed  cord,  he  highly  ap- 
proves. 

London  Hospitals. 

The  hospitals  of  London,  of  which  I  shall 
give  a  passing  notice,  are  Guy^s,  King's  College 
Hospital,  University  College  Hospital,  West- 
minster, Bartholomew's,  the  National  Hospi- 
tals for  Epileptics  and  Paralytics,  the  Chil- 
dren's Hospital,  and,  finally,  the  London  Hos- 
pital; and  in  the  order  in  which  I  have  named 
them. 

And,  first, 

Guyh  Hosjntal. 

This  extensive,  and  deservedly  reputable 
hospital,  occupies  a  low  situation,  on  the 
south  side  of  the  Thames,  between  Black- 
friar's  and  London  Bridges,  not  far  from  the 
river.  And,  while  its  site  is  low,  and  its 
surroundings  crowded,  Guy's  hospital  has 
many  advantages;  among  which  I  may  men- 
tion  its  substantial  structure,  good  arrange- 


27 

mcnt,  excellent  museum,  attentive  nurses, 
gentlemanly  residents,  and  very  able  corps  of 
visiting  physicians  and  surgeons. 

This  hospital  has  a  general  variety  of  dis- 
ease, medical  and  surgical ;  as  well  as  an  ex- 
tensive class  of  shin  diseases  under  the  very 
judicious  care  of  Dr.  Fagg.  Ti/plius  fever 
appeared  to  predominate;  though  scrofulous, 
tuberculous,  neuralgic,  and  a  vast  variety  of 
chronic  affections  are  on  hand ;  as  well  as 
many  passive  inflammatory  diseases,  of  a  less 
chronic  character.  And  I  noticed  among 
others,  cases  of  albuminuria,  exophthalmia, 
etc.  Dr.  MoxoN,  a  gentleman  of  deservedly 
high  standing  there,  showed  me  a  case  of 
2)oplifeal  aneurism^  cured  by  pressure  upon 
the  femoral  artery,  kept  up  for  twenty-four 
hours,  by  the  fingers  of  students,  taking  turns. 
The  clot  was  perfect,  and  the  tumor  without 
pulsation,  leaving  no  doubt  as  to  the  result. 

The  surgical  treatment'at  Gruy's  is  decidedly 
conservative  and  judicious;  Drs.  Cock  and 
FoRSTER  operating  with  dexterity  and  appa- 
rent care ;  chloroform  being  administered  by 
the  large  oil  silk  or  gutta-percha  bag,  contain- 
ing the  anassthetic,  with  a  due  amount  of  air; 
the   invention   of  Dr.   Clover,   of  London. 


28 

But  while  I  liked  the  surgery,  I  was  not  pnr- 
ticularly  pleased  with  the  mode  of  adminis- 
teriog  the  chloroform,  preferring,  from  all  I 
could  discover,  the  folded  napkin  to  this  ap- 
paratus, as  being  decidedly  more  convenient, 
and  less  formidable  in  appearance. 

Patients    here    are    well    nouri&lied^    as    in 
Scotland ;  milk,  with   broths,   ^^^^  toast,  etc., 
being  freely  allowed;  and  the  medical  treat- 
ment, though  very  conservative,  is  generally 
judicious.     I  could  not  help  thinking,  how- 
ever, that  quinine  or  extract  of  bark,  with  the 
nourishment,  might  arrest,  or  very  much   cut 
short  the  numerous  cases  of  typhus,  and  even 
the  ^^^  of  typhoid  fever;  and,  also,  that  more 
local  bleeding,  or  counter-irritation,  with   the 
nourishment,  and  in  some  cases  the  quinine, 
in  the  pneumonia  and   pleurids,  as  it  occurs 
there,  might,  in  many  cases,  hasten   the  reso- 
lution of  pneumonia,  and  lessen  the  frequency 
of  pleuritic    effasion    in    pleurisy.     Of   this, 
however,   I   cannot  be  certain.     I  am  quite 
certain,   however,  that  I  should  modify  the 
treatment  in  that  direction,   were  the    cases 
under  my  care,  and  compare  the  results. 

Drs.    MoxoN,    Eastes,   Fagg,   Forster, 
Cock,  and  others  there,  treated  me  with  great 


29 

politeness;  ia  Aict,  with  a  degree  of  cordi- 
ality I  had  hardly  expected  in  a  large  London 
Hospital.  This,  however,  was  my  first,  but 
not  the  last  happy  disappointment  of  this 
character,  while  visiting  the  London  hospitals, 
CarhoUc  acid  was  being  introduced  into  Guy's, 
afcer  the  manner  of  Professor  Lister,  of  Glas- 
gow, and  with  apparent  good  results. 

King's    College    Hospital. 

This  hospital,  though  not  large,  is  well  lo- 
cated, being  on  the  North  side  of  the  Thames, 
upon  an  elevation  of  ground,  opposite  King's 
College,  close  by  the  strand,  and  about  half 
way  from  St.  Paul's  Cathedral  to  the  Houses 
of  Parliament.  The  building,  though  by  no 
means  magnificent,  is  still  very  convenient, 
and  well  arranged;  commanding  some  of  the 
best  medical  and  surgical  talent  in  London; 
among  whom  I  may  mention  Drs.  Ferguson, 
Johnson,  etc.  The  residents,  Drs.  Smith, 
Todd,  and  others,  gave  me  every  attention,  as 
did  Professors  Johnson  and  Ferguson,  the 
latter  having  the  general  supervision  of  the 
surgical  wards,  as  appeared,  and  Johnson  of 
the  medical.  Professor  Johnson  is  doing 
much  with  the  laryngf scope;  and  I  noticed, 


30 

that  in  Lis  instructions  to  his  numerous  cla<;s, 
he  advised  them  particularly,  and  as  I  thought 
very  judiciously,  when  about  to  use  the  laryn- 
goscope, to  be  sure  and  keep  the  patient  very 
quiet^  to  have  the  hreatliing  continued  natu- 
rally; and  to  be  sure  and  have  a  good  light  in 
a  darkened  room;  important  precautions,  too 
often  overlooked,  and  of  course  rendering  the 
observation  more  or  less  imperfect.  Dr. 
Johnson  is  Professor  of  Practice  of  Medicine 
in  King's  College,  I  believe. 

The  only  criticism  I  could  offer  in  relation 
to  the  treatment  of  the  numerous  cases  in 
King's  College  Hospital,  is  their  failure  to 
use,  as  it  appeared  to  me,  sufficient  local  de- 
pletion or  counter-irritation,  in  local  inflamma- 
tory affections;  and  especially  in  pleuritis, 
even  though  general  tonics  with  good  nourish- 
ment might  be  required,  as  is  doubtless  very 
generally  the  case.  I  was  led  to  this  reflec- 
tion, in  my  own  mind,  in  consequence  of  the 
great  frequency  of  pleuritic  effasion,  of  a  very 
troublesome  character,  fjllowing  pleurisy  in 
their  cases;  little  more  than  a  leech  or  two 
beinoj  applied,  in  many  cases,  as  appeared; 
which  I  should  think  could  do  little  or  noth- 
ing towards  subduing  the  inflammation,    and 


31 

thereby  preventing  effusion.  It  is  possible, 
however,  that  my  remedies  for  local  depletion 
or  counter-irritation,  might  utterly  fail  in 
their  cases,  of  averting  these  very  unpleasant 
results.  I  would  try  them  however;  increas- 
iog,  if  necessary,  as  a  consequence,  with  the 
nourishment,  the  stimulants  and  tonics. 

King's  College  Hospital,  however,  is  an  ex- 
cellent one ;  its  resident  and  visiting  physicians 
and  surgeons  being  second  to  none,  in  my 
opinion.  The  hospital,  too,  has  a  long  list  of 
illustrious  names,  thafc  have  been  an  honor  to 
our  profession  throughout  the  world. 

University/   College  Hospital. 

This  excellent  hospital,  in  connection  with 
the  University  of  London,  is  very  pleasantly 
situated  on  a  rise  of  ground,  North  of  the 
Thames,  and  about  a  mile  North-westerly  from 
the  Houses  of  Parliament.  It  is  an  airy, 
cleanly,  and  well  arranged  and  conducted  hos- 
pital; having,  as  appeared  to  me,  a  better 
class  of  patients  than  most  of  the  Londi  n 
hospitals.  Dr.  Fox,  to  whom  I  had  a  letter 
from  Professor  Bennett,  treated  me  very  po- 
litely, and  I  was  very  well  pleased  with  the 
treatment  pursued  in  the  medical   and  surgi- 


cal  cases;  and  especially  so,  to  find  the  method 
of  my  friend,  Dr.  Swinburne,  of  New  York, 
for  treatiog  fractures  of  the  thigh,  in  use 
there,  and  highly  approved.  As,  however, 
my  observations  here  were  somewhat  limited, 
on  account  of  time,  I  will  not  attempt  to  par- 
ticularize. I  saw  enough  of  it,  however,  to 
satisfy  me  that  it  is  a  first  class  hospital,  and 
admirably  conducted,  by  able,  efficient,  and 
first  class  physicians  and  surgeons,  gentlemen 
in  every  sense  of  the  word.  Dr.  Squarey 
deserves  honorable  mention,  in  connection 
with  this  hospital.  He  treated  me,  as  did  also 
Dr.  Fox,  with  the  greatest  politeness  and 
kindness. 

Westminster  Hospital. 
"Westminster  Hospital  is  the  oldest  in  Lon- 
don, I  believe,  being  situated  at  West  End, 
near  the  Houses  of  Parliament,  and  but  a 
short  distance  from  Westminster  Bridge;  and 
though  well  built  and  arranged,  it  is  not  very 
capacious,  accoiumodating,  I  should  think, 
from  one  to  two  hundred  patients.  Many  out 
patients  are,  al-o,  prescribed  for  there,  as  I 
noticed. 

Though  the    situation  of  tbis   hospital   is 
not  very  elevated,  the. surroundings  arc  good, 


and  the  usual  variety  of  cases,  medical  and 
surgical,  were,  as  appeared  to  me,  above  the 
average,  in  the  London  Hospitals.  Its  walls 
are  colored  a  sky  hlue;  an  experiment  for  re- 
lieving the  eyes  of  the  patients,  as  they  lie 
facing  them  J  and  I  was  assured  that  the  re- 
lief was  very  considerable,  as  one  might 
readily  suppose. 

Among  the  physicians  and  surgeons  I  met 
in  this  hosp-'tal,  were  Sir  Duncan  GtIbb, 
IIadgliffe,  Holthouse,  Anstie,  and  Buz- 
ZARB,  besides  residents;  all  of  whom  treated 
me  with  great  politeness  and  even  kindness, 
Dr.  Radoliffe  taking  me  in  his  carriage  from 
the  hospital,  to  show  me  West  End,  the 
piilace,  parks,  residences,  etc.;  and  kindly 
offering  to  do  anything  he  could  for  me  while 
in  London. 

Sir  Duncan  Gibb  is  doing  a  good  work 
with  the  laryngoscope.  And  I  was  pleased 
to  find  the  treatment  of  inflammatory  affec- 
tions more  in  accordance  with  my  own  views, 
than  in  most  of  the  other  hospitals;  and,  as 
appeared  to  me,  with  better  results.  In  fact, 
some  of  the  able  physicians  in  this  hospital, 
concurred  with  me,  in  the  opinion  that  they 
were,  very  likely,  too  much  on  the  extreme 
4 


34 

ID  trusting  so  exclusively  to  nature,  for  the 
cure  of  disease;  and,  especially,  in  certain  in- 
Sammatory  affections.  I  suggested  to  thena 
leptandrin,  ns  a  laxative,  cbolagogue,  and 
alterative,  as  I  had  in  the  Royal  Infirmary  of 
Glasgow,  in  neither  of  which  had  it  been  in 
use.  And,  I  may  say,  that  Drs.  Leishman 
of  Glasgow,  and  Buzzard,  of  London,  were 
both,  apparently,  very  anxious  to  become 
acquainted  with  its  therapeutic  virtues,  the 
former  administering  some,  which  I  gave  him, 
with  apparent  good  effect,  while  I  was  there. 
I  must  say,  in  conclusion,  that  my  recollec- 
tions of  the  physicians  and  surgeons  of  West- 
minster Hospital  are  of  a  very  pleasant  char- 
acter. And  I  regard  the  treatment  of  its 
cases,  medical  and  surgical,  as  inferior  to  none 
in  London. 

St.  Bartholomew's  Hospital. 

Bartholomew's  Hospital  is  very  pleasantly 
situated  on  a  rise  of  ground  North  of  the 
Thames,  between  Blackfriar's  and  London 
Bridges,  and  near  St.  Paul's  Cathedral;  thus 
making  it  nearly  opposite  Guy's  on  the  South 
side,  as  we  have  seen. 

Bartholomew's,    though    its   surroundings 


are  crowded,  is  a  splendid  building,  and  well 
arranged;  being,  also,  the  largest  as  I  believe, 
and  best  endowed  hospital  in  London.  Many 
out  patients,  I  noticed,  were  prescribed  for 
here.  The  class  of  cases  in  Bartholomew's 
appeared  as  good  as  an  average  in  London  5 
and  the  variety,  of  course,  as  great  or  greater. 
Dr.  Ure,  a  resident,  was  very  free  to  admit 
the  superiority  of  the  "American  method"  of 
treating  fractures  of  the  thigh,  which  they 
have  adopted,  most  of  their  cases  being  treat- 
ed by  Dr.  Swinburne's  method  of  pully  and 
weight;  but  some,  or  one  at  least,  by  Dr. 
Nathan  Smith's,  &s  I  noticed,  with  which 
he  also  appeared  quite  well  pleased. 

Dr.  Farre,  one  of  the  principal  among  the 
visiting  physicians,  and  well  deserving  all  the 
reputation  he  enjoys,  at  home  and  abroad, 
very  kindly  showed  me  the  medical  cases  of 
interest;  and  I  could  find  no  fault  with  his 
prescriptions.  All  his  treatment  appeared 
based  upon  sound  common-sense  principles. 
For  lead  poisoning  he  used  iodide  of  potas- 
sium; and,  when  attended  with  paralysis, 
followed  with  strychnia;  and,  as  appeared, 
with  very  good  success,  as  might  be  expec- 
ted.    In  eptlepsT/y  the  Dr.,  in  addition  to  such 


3Q 

other  fcreatment  as  may  be  indicated,  keep^ 
the  back  of  the  head  wet  vrith  cool  water,  for 
the  purpose  of  contracting  the  blood-vessels  of 
the  cerebellum,  as  he  informed  me.  He  uses, 
also,  the  same  application  in  deUrium  tremens, 
and  fl'T  a  similar  purpose.  And  I  must  say^ 
in  conclusion,  taking  everything  into  account, 
that  Bartholomew's  is  the  best  hospital  iir 
London,  if  not  in  the  British  Islands. 

National  Hospital  for  Epileptics  and  Para- 
lytics. 

I  visited  this  hospital,  situated  between 
Bartholomew's  and  Westminster  Hospitals, 
though  considerably  to  the  north,  by  special 
invitation  of  Dr.  Radcliffe  of  the  Westmins- 
ter, who,  with  Dr.  Ramskill,  of  the  London 
Hospital,  may  be  regarded  as  having  the 
principal  supervision.  It  is  well  situated  and 
arranged  for  the  class  of  cases  that  it  con- 
tains; its  surroundings  being  also  good,  in  a 
part  of  Queen's  Square. 

Ej)ile2ytics  are  treated  here  on  general  com- 
mon-sense principles,  tbe  general  and  locai 
derangements  being  corrected  as  far  as  possi- 
ble; and  then  the  bromide  of  potassium,  ia 
fifteen  or  twenty-grain  doses,  three  times  a 


37 

day,  is  perhaps  more  frequently  resorted  to 
than  any  other  remedy,  and  as  appeared,  with 
a  measure  of  success.  I  would  prefer,  how- 
ever, the  bromide  of  ammonium  of  the  two, 
from  what  I  know  of  their  effects. 

Paralytics  are  also  treated  in  this  hospital 
on  general  principles,  the  patients  being  re- 
quired to  take  such  exercise  as  may  tend  to 
bring  volition  to  bear  upon  the  paralyzed 
muscles;  or  in  case  of  inability,  to  have  it 
done  by  the  nurse;  the  patient,  of  course, 
doing  all  that  is  possible  to  assist;  thus  ac- 
complishing, as  I  have  done,  very  much  in  the 
recovery  of  partially,  or  even  totally  paralyzed 
limbs.  Electricity  is  also  brought  to  bear  in 
many  cases,  with  more  or  less  success.  I  will 
only  say  in  conclusion,  that  choreaj  which  is 
also  admitted  here,  appears  to  be  very  gene- 
rally treated  with  cod-liver  oil,  which  is  doubt- 
less an  excellent  remedy  in  their  hospital 
cases.  I  would  have  added,  however,  in  many 
of  the  cases,  the  blood  tonic,  carbonate  of  iron, 
the  nsrve  tonic,  oxide  of  zinc,  with,  in  some 
cases,  the  gastric  or  intestinal  tonic,  rhubarb, 
combined,  of  each  equal  parts,  in  moderate 
doses,  three  times  a  day. 
4* 


38 


ChUdren^s  Hospital. 

The  Children's  Hospital,  near  Queen^a 
Square,  and  not  far  from  the  National,  has 
seventy-five  heds,  all  for  children;  and  they 
are  well  filled.  The  resident,  Dr.  Williams, 
a  perfect  gentleman,  was  at  great  pains  to 
show  me  the  cases,  many  of  which  were 
of  interest.  It  was  here  that  I  had  the 
hest  opportunity  of  examining  the  imperfec- 
tion of  the  inciBOi'  teeth  of  children  heredita- 
rily syphilitic.  The  incisors  in  such  cases 
being  often  not  only  very  imperfectly  devel- 
oped, but  also  generally  at  a  little  distance 
apart. 

The  cases  are  well  treated  ia  the  Child- 
ren's Hospital,  and  perhaps  more  nearly  in 
accordance  with  my  own  views,  than  in  any 
other  I  visited  in  London.  What  plen^ed 
me  most  here,  however,  was  to  see  the  little 
ones,  with  a  board  across  their  cribs  for  a 
table,  and  a  cup  of  milk,  with  such  other 
nourishing  food,  as  each  might  require.  All, 
however,  had  the  milk.  And  the  way  they 
appeared  to  relish  it,  should  satisfy  any  one 
that  it  was  clearly  indicated.  In  fact,  my 
mind  still  loves  to  linger  on  that  sceiie.     But 


39 

I  must  proceed  to  consider  the  last  I  sliail 
mention  here  of  the  hospitals  of  London. 

The  London  Hospital. 

The  London  Hospital ,  very  well  situated  on 
the  north  side  of  the  Thames,  to  the  north- 
east of  the  Tower  of  London,  north  of  the 
London  Docks,  and  about  three  miles  easterly 
from  St.  Paul's  Cathedral,  is  one  of  the  best 
in  London,  having  about  four  hundred  beds. 
Many  out  patients  are  also  prescribed  for,  in- 
cluding diseases  of  the  eye  and  skin,  the  lat- 
ter by  Dr.  Lawrence,  and,  as  appeared  to 
me,  very  judiciously;  the  ophthalmoscope 
being  used  as  a  means  of  diagnosis  in  the 
ophthalmic  cases,  and  with  a  degree  of  accu- 
racy I  have  seldom  noticed  anywhere.  Oxide 
of  zincy  I  noticed,  was  often  used  locally  in 
various  cutaneous  eruptions  of  a  vesicular 
character,  by  Dr.  Lawrence,  and  apparently 
with  good  effect,  as  I  have  often  used  and 
seen  it  used  in  this  country. 

The  milk  nourishment  is  used  to  the  full 
extent  in  this  hospital ;  and  all  the  residents, 
who  treated  me  with  the  greatest  politeness, 
as  well  as  Dr.  Eamskill,  visiting  physician, 
assured  me  that  they  were  well  satisfied  with 


40 

its  effects.  Other  varieties  of  nourisliment 
are,  of  course,  added ;  however,  in  many,  and 
perhaps  most  of  the  cases,  as  indicated,  very 
much  in  accordance  with  my  own  notions 
on  the  subject,  as  already  freely  expressed. 

Dr.  Ramskill,  who  is  doubtless  one  of  the 
very  best  physicians  in  London,  being,  as  I 
have  already  stated,  one  of  the  physicians  to 
the  National  Hospital  for  Epileptics  and  Par- 
alytics^ showed  me  a  very  interesting  case  of 
abdominal  hi/per8e.miaj  apparently  involving 
all  the  abdominal  viscera  and  structures — 
such  a  case  as  I  do  not  remember  to  have 
seen  before.  This  case,  with  two  cases  of 
loose  kidney  that  I  saw  and  examined  in 
Edinburgh,  one  with  Sir  James  Simpson, 
and  the  other  in  the  Eoyal  Infirmary,  I  re- 
garded as  new  to  me,  and  they  must  be,  I 
think,  quite  rare. 

I  saw  at  the  London  Hospital  also,  one  of 
the  worst  cases  of  chorea^  the  patient  being  a 
man,  that  I  never  met  with,  and  as  Dr.  Rams- 
kill  very  politely  asked  me  what  to  do  for 
him,  I  prescribed  a  mixture  of  equal  parts 
of  carbonate  of  iron,  oxide  of  zinc,  and  rhu- 
barb; to  commence  with  six  grains  three 
times  a  day,  and  gradually  increase ;  morphia^ 


41 

wliicli  he  had  been  taking,  I  believe^  on  his 
own  responsibility,  and  all  other  remedies, 
except  cold  to  the  back  of  the  head  and  neck, 
to  be  discontinued;  the  latter  being,  as  I  be- 
lieve, Dr.  Ramskill's  prescription,  that  would 
not  interfere  with  my  remedies.  Twenty  days 
after,  on  my  return  from  Paris,  I  was  surprised 
and  highly  gratified  to  find  the  patient  won- 
derfully improved,  so  as  to  be  up,  rolling  ban- 
dages with  a  machine;  whether  the  result  of 
my  prescription  and  remedies,  that  had  been 
faithfully  given,  or  in  spite  of  them,  I  cannot 
say.  My  opinion  is,  however,  that  while  my 
medicines  helped  him,  the  stopping  of  the 
opiate,  which,  as  I  learned,  was  faithfully 
done,  did  more  to  effect  the  very  great  im- 
provement, by  lessening  the  cerebro-spinal 
congestion  and  derangement.  It  matters  not, 
for  the  patient  was  almost  frantic  with  delight, 
giving  all  credit  to  my  remedies;  with  which, 
in  fact,  I  have  never  failed  in  effecting  a  cure 
in  such  cases  that  I  remember,  though  not  so 

I  cannot  close  my  account  of  this  excellent 
hospital  without  again  referring  to  the  very 
great  politeness  to  me  of  all  the  residents, 
and  Dr.  Ramskill  in  particular.     Theyinvi- 


42 

ted  me  to  lunch  with  them  in  the  hospital,  on 
their  fine  bread  and  butter  and  excellent  Eng- 
lish milk,  and  extended  to  me  many  kind 
favors,  upon  which  my  memory  delights  to 
linger;  and  as  this  completes  my  account  of 
the  London  hospitals,  I  am  happy  to  say  that 
the  treatment  I  received  in  them  all,  as  well 
as  in  those  of  Scotland,  was  worthy  of  the 
noble  men,  of  a  noble  profession,  by  which  they 
are  conducted. 

Liverpool  Hospitals. 

The  Royal  Infirmary  of  Liverpool  is  all 
that  I  will  mention  in  this  city.  It  is  quite 
well  situated,  and,  though  not  very  extensive, 
is  well  arranged,  and  apparently  well  con- 
ducted. Hospital  gangrene,  however,  was 
fearfully  prevalent  when  I  was  there,  which 
cast  a  gloom  over  all  their  best  directed  ef- 
forts. They  had  been  unsuccessful  in  their 
attempt  to  introduce  carbolic  acid,  and  I 
learned  from  the  resident  and  visiting  physi- 
cians, who  were  very  kind  to  me,  that  the 
same  gangrenous  tendency  prevailed  at  that 
time  throughout  the  city,  which  fully  account- 
ed in  my  mind,  for  their  unfavorable  condi- 
tion.    For  I  could  not  detect  any  local  cause, 


43 

either  in  the  location  or  surroundings,  or 
management  of  the  hospital,  whereby  to  ac- 
count for  it. 

Dublin  Hospitals. 

As  much  of  my  time  was  taken  up  while  in 
Dublin  in  attending  the  British  Medical  As- 
sociation, and  as  ma'ny  of  my  observations  in 
the  Dublin  hospitals  were  published  in  this 
country,  in  connection  with  my  account  of  the 
proceedings  of  the  Association,  I  do  not  feel  at 
liberty  to  repeat  them.  I  may  be  permitted  to 
state,  however,  that  among  the  excellent,  well 
conducted  and  generally  quite  well  located 
Dublin  hospitals,  I  was  more  especially  inter- 
ested in  Mercer's,  situated  in  a  central  part 
of  the  city,  near  Trinity  College  ;  Sir  Patrick 
Dun's  occupying  a  more  elevated  position,  in 
a  north-westerly  direction  from  Trinity  Col- 
lege, and  in  a  less  crowded  part  of  the  town ; 
Hardiuickcj  and  the  Richmond  District  Lunatic 
Asi/luniy  south  of  the  river,  in  the  south-east 
part  of  the  city,  tolerably  well  situated;  the 
Rotunda^  or  great  Li^ingin  Hospital,  also  south 
of  the  Liffey,  and  to  the  south-east  of  the 
Trinity  College  and  the  General  Post  Office ; 
and   St.  Mark's,  or  the  Eye  Infirmary  of  Sir 


u 

AViLLiAM  Wilde,  near  Merion  Square,  in  a 
central  part  of  the  city. 

Mercer^ s  Hospital. 

At  Mercer's  Hospital,  which,  though  not 
very  extensive,  is  a  good  one,  I  met  Drs. 
Moore  and  Butcher,  the  former  being  visit- 
ing physician  and  the  latter  visiting  surgeon, 
The  building,  though  not  magnificent,  is  a  con- 
venient one;  and  the  medical  and  surgical 
treatment  appeared  to  me  very  judicious.  Dr. 
Butcher,  the  accomplished  surgeon,  apolo- 
gizing for  the  small  number  of  cai^es  of  interest 
in  his  department  at  that  time,  invited  me  to 
liis  residence  to  see  his  drawings,  casts,  patho- 
logical specimens,  etc.,  mostly  illustrating  sur- 
gical cases  f.f  great  interest  that  have  fallen 
under  his  care.  I  need  not  say,  that  with  his 
explanations,  and  remarks  in  relation  to  them, 
it  would  have  repaid  even  a  very  long  journey; 
and  as  I  passed  through  his  library,  he  pointed, 
with  veil/  great  npjxirent  sat  I  s[f action^  to  Pro- 
fessor Gross'  Surgery,  expressing  in  strong 
terms  his  high  appreciation  of  the  work;  thus 
sffording  me  the  satisfaction  of  knowiog  that 
one  of  tbe  very  first  surgeons  in  the  British 
Islands,  if  not   in   Europe,  knew  how  to  ap- 


4e^ 

prcciatc  tho  work  of  our  great  American  Sur- 
geon. 

Sir  Patrick  Dun's  Hospital. 

Sir  Patrick  Dun's  is  larger  than  Mer- 
cer's Hospital,  and  occupying  a  more  elevated 
and  less  crowded  position,  is  in  every  essen- 
tial respect  a  very  excellent  one.  In  this  hos- 
pital, as  well  as  afc  Mercer's,  Prof.  Moore 
showed  me  cases  of  malignant  "  febris  nigra/' 
or  sjjotted  /every  as  it  is  called  in  America, 
then  prevailing  there,  a  very  large  proportion 
of  the  cases  having  proved  fatal.  Some  were 
convalescent,  however;  and  I  was  gratified  to 
find  that  the  treatment  pursued  was  very 
similar  to  that  generally  most  successful  with 
us;  as  tonics,  stimulants,  anti-zymotics,  coun- 
ter-irritants, good  nourishment,  etc.  Aside 
from  these,  there  were  about  the  usual  variety 
of  medical  and  surgical  cases;  and  all,  as  ap- 
peared to  me,  very  judiciously  treated. 

Hardwiche  Hospital. 
I  was  introduced  to  this  hospital,  which  is 
closely  connected  with  the  Richmond  District 
Lunatic  Asylum,  by  Professor  Banks,  Vis- 
iting Physician,  who  is  also  Counselling 
Physician   at   the    Lunatic    Asylum.     They 


46 

have  about  the  usual  variety  of  medical  aud 
surgical  cases;  the  hospital  being  also  exten- 
sive and  quite  well  arranged.  And  I  need 
not  say,  that  under  the  general  supervision 
of  such  men  as  Banks  in  the  medical,  ana 
KiRKPATRiCK  in  the  surgical  departments, 
the  treatment,  medical  and  surgical,  cannot 
but  be  judicious.  Dr.  Kirkpatrick  exhib- 
ited to  me  his  numerous  cases  of  diseased 
bones  and  joints,  treated  by  incision  and  the 
deep  introduction  of  caustic  potassa  cum  calce^ 
as  reported  by  him  to  the  British  Medical 
Association  in  August,  1867  j  and  I  am  com- 
pelled to  say,  that  the  success  of  his  treat- 
ment, in  the  numerous  cases  I  examined,  was 
greater  than  I  have  ever  witnessed  from  any 
other.  For  a  full  account  of  his  mode  of 
treatment,  see  Half- Yearly  Compendium  of 
Medical  Science^  of  January,  1868,  page  154; 
and  also  British  Medical  Journal  of  August 
31st,  1867. 

Richmond  District  Lunatic  Asylum. 

The  Richmond  District  Lunatic  Asylum,  in 
close  connection  with  the  Hardwicke  Hospital, 
is  on  a  large  scale;  quite  well  arranged,  and 
admirably  conducted ;  Prof.  Banks,  and  Dr. 


47 

Lalor,  in  cliarge,  showing  mc  every  possible 
politeness,  and  aS^ording  every  facility  for  a 
thorough  examination.  I  have  rarely,  if  ever, 
seen  a  greater  variety  of  lunatics;  including 
those  of  Trianiay  monomania j  dementiay  morai 
insanity,  tdiotismf  etc.,  under  better  control, 
with  so  little  apparent  restraint ;  Dr.  Lalor 
and  Prof.  Banks  being  generally  greeted  by 
them  with  great  cordiality  and  consideration ; 
the  former  stopping  to  drop  a  word  of  comfort 
for  the  depressed,  and  the  latter  to  hold  & 
lively  chat  with  such  as  were  elated  at  the 
idea  of  being  some  great  personage,  as  one 
Geor<je  IY.,  imagining  that  he  could  draw 
rain  from  heaven,  turn  everything  into  gold, 
etc.,  very  politely,  at  the  Doctor's  suggestion, 
explaining  to  me  exactly  how  he  did  it,  etc. 
Regular  schools,  for  reading,  writing,  singing, 
etc.,  are  maintained,  and  with  a  degree  of 
order  that  was  really  astonishing  to  me.  Th« 
mental  and  moral  treatment  there  is  excellent, 
and  the  physical^  such  as  is  indicated,  to  cor- 
rect any  deviation  that  may  be  discovered 
from  the  standard  of  health,  just  as  it  should 
be,  so  far  as  I  could  discover. 

I  may  add,  in   this  connection,  that   Dr, 
Banks  showed  me  at  the  Hardwickc  Hospi- 


48 


fal,  cases  of  the  putrid  or  spotted  fiverj  in 
addition  to  those  so  kindly  shown  to  me  ia 
Mercer's  and  Sir  Patrick  Dun's  Hospitals 
by  Profes=5or  Moore;  and  Dr.  Lalor  also  ex- 
hibited to  me  exact  drawiogs  of  the  eruption, 
as  it  had  occurred  in  the  various  cases;  show- 
ing, as  with  our  cases  in  America,  a  great 
variety  of  appearance,  which,  with  the  simi- 
larity of  the  symptoms  generally  to  the  dis- 
ease as  it  occurs  with  us,  may  be  regarded  as 
proving  their  identity  beyond  doubt.  And  I 
will  only  add,  that  having  seen  and  treated 
many  cases  of  malignant  congestive,  putrid^  or 
spotted  fever^  as  it  is  more  generally  called 
with  us,  I  have  no  hesitation  in  giving  it  as  my 
opinion,  that  it  is  essentially  a  putrid,  malig- 
nant congestive  fever,  caused  by  animal  miasms 
and  contagions,  producing  fermentation  in,  or 
putridity  of  the  blood  and  its  consequences ; 
and  distinct  from  cerebro-spinal  meningitis, 
produced  by  marsh-miasm,  with  perhaps  a 
slight  combination  of  animal  miasm  in  some 
cases,  but  not  necessarily,  perhaps. 

Spotted  fever  occurred  endemically  and 
fearfully  at  Carthage,  in  Jefferson  county,  New 
York,  during  the  winter  and  spring  of  1865, 
during  which  time  a  number  of  ©ases  oeeurred 


49 

ia  Watertown,  Adams,  Henderson,  and  Ellis- 
burgh,  in  the  same  county;  having  been  evi- 
dently introduced  into  Watertown  by  a  child 
that  came  down  with  it  after  visiting  Car- 
thage ;  and  to  Adams,  probably  by  the  cloth- 
ing of  a  gentleman  who  went  to  Carthage  to 
attend  the  funeral  of  persons  dead  with  it;  and 
to  Eilisburgh,  and  Henderson,  probably  from 
Adams.  And  as  I  was  at  that  time  at  my  coun- 
try-seat in  Adams,  I  saw  eleven  of  the  malig- 
nant cases  that  occurred  in  that  vicinity, 
three  of  which  were  dying  when  I  was  called 
to  them,  without  cerebro-spinal  inflammation. 
Six  cases  I  treated  from  the  first,  three  of  which 
recovered;  the  three  fatal  cases  only,  as  I 
believe  from  the  symptoms,  having  had  cere- 
bro-spinal inflammation;  but  all  of  them 
general  congestion,  involving  of  course,  with 
other  parts,  the  cerebro-spinal  membranes. 
Two  cases  I  saw  in  consultation,  both  proving 
fatal;  one  from  cerebro-spinal  inflammation, 
the  other  from  general  congestion  depending 
upon  a  putrid  dissolved  state  of  the  blood, 
as  was  clearly  evident.  The  treatment  that 
proved  most  effectual  in  these  cases,  and,  so 
far  as  I  could  learn,  in  the  Dublin  cases,  and 
those  in  Ireland  generally,  consisted  in  the  use 


50 

of  stimulants,  tonics,  good  nourishment,  anti- 
zjmotics,  and  counter-irritants  for  cerebro- 
spinal or  other  local  inflammations  when  they 
occurred;  and  in  some  rare  cases,  alteratives. 
I  may  also  add,  that  I  saw  about  the  same 
number  of  less  malignant  cases  in  Adams  and 
vicinity  daring  the  prevalence  of  the  spotted 
fever  there,  all  of  which  recovered,  after  suffer- 
ing for  longer  or  shorter  periods,  generally  after 
exposure  to  malignant  cases,  precisely  in  ac- 
cordance with  the  observations  of  Dr.  Charles 
LiNGEN,  of  Hereford,  Ireland;  for  a  full  ac- 
count of  which  see  Half-  Yearly  Compendium 
of  Medical  Science,  page  97;  and  also  British 
Medical  Journal  for  July  27th,  1867,  page 
61,  etc. 

I  would  suggest,  then,  the  propriety  of 
making  a  distinction  between  malignant  con- 
gesHve,  putridj  or  sjjovted /ever,  always  a  putrid 
disease,  depending  upon  either  an  animal 
miasm  or  contagion,  and  cerebrospinal  men- 
ingitis, necessarily  injQammatory,  and  often, 
perhaps  mainly,  of  paludal  origin,  as  we  have 
seen.  This  view  will  correspond  more  nearly 
with  the  views  of  our  trans-Atlantic  breth- 
ren, and  is  the  one  I  have  entertained  for 
years,  being  confirmed  by  the  casos  I  saw  in 
the  Dublin  HoepitaU. 


51 


Dublin  Lying-in  Hospital. 
The  Rotunda,  or  Dublin  Lying-in  Hospital, 
is  admirably  arranged  and  conducted ;  being, 
I  believe,  the  largest  of  the  kind  in  the 
world.  And  I  will  only  add,  in  addition  to 
the  description  that  was  published  in  this 
country  from  me,  while  there,  that  all  the 
improvements  in  obstetrical  practice  are  intro- 
duced here  by  Dr.  Deniiam  and  his  able  as- 
sistants, as  soon  as  discovered  to  be  such.  I 
need  hardly  say  that  the  method  of  reducing 
or  replacing  prolapped  cord,  suggested  by  my 
friend,  Professor  Thomas,  of  New  York,  is 
not  only  appreciated  here,  but  deservedly  so, 
by  all  distinguished  obstetricians  with  whom 
I  conversed  abroad. 

St.  Marie  s  Oplitliahnic  Hospital 
St.  Mark's  Ophthalmic  Hospital,  near  Morion 
Square,  under  the  general  supervision  of  Sir 
Wm.  Wilde,  is  an  excellent  one,  and  well  con- 
ducted. As,  however,  the  treatment  of  the  va- 
rious diseases  of  the  eye  corresponds  so  nearly 
with  the  treatment  at  the  Grlasgow  Eye  Infir- 
mary, under  the  care  of  Drs.  McKenzie  and 
IIainey,  already  described,  I  will  not  attempt 
a  description  of  it.     It  is  due,  however,   to 


52 

Sir  William,  and  Dr.  Wilson,  that  I  should 
acknowledge  their  very  great  politeness  in 
aiding  me  to  see  their  numerous  and  interest- 
ing cases,  embracing  the  usual  variety ;  all  of 
which  appeared  to  be  very  judiciously  treated, 
so  far  as  I  was  able  to  judge. 

It  will  be  seen,  then,  that  the  variety  and 
character  of  diseases,  in  the  Dublin  hospitals, 
may  be  regarded  as  corresponding  with  what 
we  have  seen  in  the  Scotch  and  English  hos- 
pitals. And,  when  we  call  to  mind  the 
noble  men,  as  Stokes,  Churchill,  Croker, 
Butcher,  Kirkpatrick,  Banks,  Moore, 
Wilde,  Lalor,  Denham,  Smith  and  others, 
that  either  have  had,  or  still  have,  a  general  su- 
pervision of  them,  I  need  not  say,  that  the  Dub- 
lin arc  among  the  best  conducted  hospitals  in 
the  world;  and  as  I  became  acquainted  with 
all  these  men,  I  am  compelled  to  say,  that  a 
more  perfect  class  of  gentlemen  cannot  be 
found,  and  while  under  great  obligations 
to  most  of  them,  I  am  especially  so  to  Drs. 
Banks,  Moore,  Lalor,  and  Denham  ;  not 
only  for  professional  civilities  and  kindness, 
but  also  for  the  most  magnanimous  hospitality ; 
an  acknowledgment  I  should  have  made,  to 
many  of  the  first  Scotch  and  English  physi- 


cians  and  surgeons,  as  Simpson,  Symf.,  Mac- 
Leod, Bennett,  Listed,  Leisiiman,  Ander- 
son, etc.,  etc. 

I  have  only  to  say,  in  concluding  my 
remarks,  concerning  the  British  hospitals,  that 
their  situation  and  surroundings  appeared  to 
me  to  modify,  very  considerably,  the  charac- 
ter of  the  various  diseases  found  in  each,  as 
might  be  expected. 

French  or  Parisian  Hospitals. 
I  have  only  to  say,  in  relation  to  the  hospi- 
tals of  Paris,  in  addition  to  what  was  published 
from  me,  while  there,"^  that  I  was  more  espe- 
cially interested  in  the  Hotel  Dieu,  situated 
on  the  island  near  Notre  Dame,  with  over 
eight-hundred  beds;  the  Larihoisi^rcy  in  the 
north  part  of  the  city,  toward  Montmartre, 
having  eight-hundred  beds;  La  Charite,  south 
of  the  Seine,  near  the  University  of  Paris ; 
BeaujoUf  Rue  St.  Honore,  near  the  Triumphal 
Arch,  in  the  direction  of  Avenue  Neuilly; 
La  P'itie,  in  the  southero  part  of  the  city, 
near  the  Garden  of  Plants,  and  the  Hospital 
of  Invalid  Soldiers,  also  south  of  the  river, 
and  in  connection  with,  or  close  by  Napo- 
liEON's  Tomb,  all  deserving  a  passing  notice. 

*  Soo  Medical  and  Surgical  Reporter,  vol.  xvii.  1867. 


54 


Hotel  Bleu. 
The  Hotel  Dieu,  situated  near  Notre  Dame, 
on  the  island,  is  an  old  and  immense  building, 
though  not  elegant  or  very  well  arranged. 
The  wards  appeared  to  me  not  well  ventilated, 
and  somewhat  filthy  for  a  Parisian  Hospital. 
It  is  about  to  be  removed  to  the  side  of  the 
island,  near  the  Rue  Napoleon,  where  it  will 
doubtless  be  reconstructed  on  the  most  ap- 
proved modern  principles.  A  great  variety  of 
medical  and  surgical  cases,  are  assembled 
here,  comparing  very  nearly  with  the  cases  in 
our  larger  American  Hospitals;  and  the  treat- 
ment is  very  similar.  They  hesitate,  however, 
about  the  use  of  anaesthetics;  and  I  think 
their  surgery  may  be  slightly  more  conserva- 
tive than  ours.  Drs.  Maisonneuve,  of  the 
Surgical,  and  Fournier  of  the  Medical  Depart- 
ment, are  active  efficient  men,  and  gentlemen. 

Lariboisiere  Hospital. 
This  excellent  hospital,  in  the  north  part  of 
Paris,  toward  Montmartre,  is  well  situated, 
arranged,  and  conducted;  being  exquisitely 
neat  and  clean.  Its  arrangements  for  heating, 
cooking,  ventilation,  washing,  etc.,  are  really 
splendid.     It   has   eight-hundred    beds,  and 


55 

when  I  wag  there,  it  had  six-hundred  patients, 
consisting  of  the  usual  variety,  among  which 
were  cases  of  enteric  fever,  pneumonia,  pleu- 
ritis,  rheumatism,  asthma,  tubercular  phthisis, 
gastro-intestinal  diseases,  etc.,  somewhat  promi- 
nent; and  receiving,  usually,  the  same  gen- 
eral and  local  treatment  we  resort  to  in 
America  for  similar  cases;  and  I  am  dis- 
posed to  regard  Dr.  Horard,  the  chief  of  the 
medical  department  of  this  hospital,  as  one  of 
the  very  best  physicians  in  Paris,  from  what  I 
saw.  He  was  at  great  pains  to  show  me  his 
cases,  as  well  as  all  the  parts  and  appurtenan- 
ces of  the  grand  structure  that  contains  them, 
and  which  he  manages  with  so  much  wisdom 
and  prudence. 

La  Charite  Hospital. 

This  hospital  is  situated  in  a  dense  part  of 
the  city,  near  the  University  of  Paris,  having 
large  accommodations,  and  being  a  very  plea- 
sant one,  considering  its  surroundings.  It  is 
well  arranged,  and  the  surgical  department, 
then  under  the  general  supervision  of  the 
late  M.  Velpeau,  was  admirably  conducted. 
The  venerable  surgeon  operated  with  a  steady 
hand,  and  as  I  noticed,  without  glasses,  though 


56 

about  eighty.  And  though  his  step  indicated 
his  agCj  he  was  then,  only  a  few  weeks  pre- 
vious to  his  death,  one.  of  the  most  lively  and 
cheerful  men  I  saw  abroad;  passing  from  bed 
to  bed,  with  a  cheering  remark  for  almost 
every  patient,  apparently  greatly  interesting 
and  pleasing  them.  And,  when  through, 
he  would  sit  an  hour  or  so,  and  prescribe 
for  the  numerons  out-patients.  He  treated 
me  with  great  politeness  and  kindness ;  and  I 
must  say,  that  a  deep  feeling  of  sadness  came 
over  me  when  the  dispatch  came,  soon  after  I 
returned  to  America  announcing  his  death. 
The  cases,  medical  and  surgical,  here,  were 
very  similar  to  those  of  other  Parisian  hospi- 
tals. The  patients,  however,  appeared  to  me 
very  cheerful,  and  comparatively  happy. 

Beaiijon  Hospital. 

This  hospital  has  an  elevated  site  on  Rue 
St.  IIoDore,  near  the  Triumphal  Arch,  having 
good  surrourdings;  and,  though  not  of  the 
largest  size  or  capacity,  it  is  an  excellent  hos- 
pital, having  a  good  variety  of  cases.  I  no- 
ticed that  Dr.  Gubler,  one  of  the  prominent 
Visiting  physicians  here,  used  hypodermic  in- 
jections of  atropia,  in  a  case  of  sciatica.     The 


57 

hospital  had  a  large  proportion  of  tuberculous 
cases,  for  a  Parisian  hospital,  it  appeared  to 
me,  many  of  them  being  tubercular  phthisis. 
Asthma,  and  emphysema  were  quite  common, 
together  with  enteric  fever,  rheumatism,  pneu- 
monia, pleuritis,  etc.  I  need  hardly  add,  that 
the  diseases  and  treatment  were  very  like  our 
American. 

La  Pitie  Hospital. 

This  hospital  rather  pleasantly  situated, 
near  the  Garden  of  Plants,  has  seven-hundred 
beds;  its  arrangements  being  as  good  as  the 
average  of  Parisian  hospitals.  Among  the 
numerous  cases,  I  noticed  quite  a  large  pro- 
portion of  tubercular  phthisis,  enteric  fever, 
pneumonia,  pleurisy,  etc.,  all  treated  very 
much  as  an  American  would  have  treated 
them,  and  I  think  very  properly. 

Many  cases  in  this,  as  well  as  in  the 
other  Parisian  hospitals,  appeared  to  be  of 
malarious  origin,  having  a  remittent  charac; 
ter,  and  involving,  with  gastro  intestinal  de 
rangements,  more  or  less  hepatic,  as  with  up. 
Typhus  fever,  though  occurring  there,  did  not 
appear  to  me  very  prevalent. 

I  have  not  referred  to  diseas  s,  the  direct 
result  of  prostitution,  either  here  or  elsewhere, 
6 


58 

for  the  reason  that  they  are  much  the  same  in 

character  everywhere ;  the  treatment,  too,  being 
similar  the  world  over,  so  far  as  I  know.  I  may 
be  allowed  to  state  here,  however,  without  any 
indelicacy,  that  their  prevalence,  according  to 
my  observation  in  the  British,  French,  and 
American  hospitals,  may  be  set  down  as  about 
equally  distributed. 

Hospital  of  Invalid  Soldiers. 

I  visited  this  splendid  hospital  for  invalid 
soldiers,  pleasantly  situated  south  of  the 
Seine,  and  in  connection  with  Napoleon's 
Tomb.  And  going,  as  I  did,  with  one  of  the 
Imperial  Guard,  who  kindly  volunteered  to 
accompany  me,  every  part  of  it  was  very  politely 
shown  to  us,  including  the  cooking,  dining 
apartments,  chapel,  etc.;  and,  though  I  saw 
nothing  of  direct  medical  or  surgical  interest ; 
the  splendid  structure,  with  such  ample  accom- 
modations, containing,  also,  the  ashes  of  the 
great  Napoleon;  and  once  graced  by  the 
ministrations  of  the  immortal  Larrey,  all  in- 
duced me  to  give  this  noble  hospital  a  passing 
notice,  with  the  others  in  Paris. 

I  may  add,  that  the  physicians  and  sur- 
geons connected    with    the!?e   hospitals,  with 


50 

whose  practice  I  became  most  acquainted, 
were  Messrs.  Maisonneuve,  Hgrard,  Yel- 
PEAU,  (since  deceased),  Gubler,  etc.,  though 
I  was  through  the  hospitals  with  many  others 
I  need  not  name,  all  of  whom  treated  me  with 
the  greatest  politeness  and  kindness,  and  es- 
pecially Messrs.  Hgrard,  Velpeau,  Gtubler, 
and  also  M.  Jaccoud,  Secretary  of  the  Inter- 
national Medical  Congress,  whom  I  had  not 
mentioned. 

Now  it  will  be  seen  that  these  various  hos- 
pitals compare  favorably  with  the  British 
Hospitals,  as  to  location,  size,  arrangement, 
variety  of  cases,  etc.  The  Lariboisiere  is  the 
best  ventilated,  best  constructed,  arranged, 
and  conducted  hospital  I  saw  in  Europe,  so 
far  as  I  was  able  to  judge.  In  fact,  its  accom- 
modations are  good  enough  for  any  one, 
no  matter  in  what  circumstances.  And  with 
the  great  similiarity  that  there  is  between  the 
character  of  disease  in  France  and  America, 
and  a  like  similiarity  of  treatment,  I  was  left 
without  any  reasonable  ground  for  criticism, 
and  will  therefore  forbear  to  offer  any.  I 
may  say,  however,  that  I  was  struck  with  one 
dissimilarity  in  the  development  of  disease.  I 
refer  to  the  frequency  of  the  primary  dcposi- 


60 

tion  of  tubercles  in  the  ryjTit,  instead  of  the 
left  lung,  as  more  frequently  occurs  with  us, 
as  I  believe  is  generally  admitted.  I  spoke 
of  this  to  GuBLERj  of  the  Beaujon  Hospital, 
who  appeared  surprised  when  I  told  him  that 
in  America  the  left  lung  is  regarded  as  the 
more  frequent  primary  seat  of  tubercular 
deposit.  In  his  hospital  it  was  evidently  the 
opposite,  and  I  concluded  from  his  remarks 
that  he  regarded  that  as  the  rule  in  France. 
In  this,  however,  I  may  have  been  mistaken. 

In  closing  this  brief  sketch  of  the  Parisian 
hospitals,  physicians,  and  surgeons,  I  feel 
bound  to  say  that  the  treatment  I  received 
from  them  will  forever  endear  to  me  the  noble 
French  people.  And  I  can  only  hope  that 
wc  in  America  may  yet  learn  to  feel  and  ex- 
ercise to  one  another  and  to  foreigners,  a 
degree  of  politeness  and  kindness,  if  not  hos- 
pitality, approximating,  at  least,  that  which 
an  American  physician  receives  in  the  British 
Islands  and  France.  Our  age,  as  a  nation, 
may  be  some  apology.  And  yet,  after  making 
this  allowance,  I  confess,  that  since  my  re- 
turn I  have  been  pained  when  I  have  made 
the  comparison. 

I  am  glad  to  be  able  to  say,  however,  that 


61 

we  have  many  exceptions ;  and  I  trust  that 
this  may  become  more  general,  till  our  civili- 
zation in  this  respect  shall  not  only  equal  that 
of  our  trans- Atlantic  brethren,  but  that  we 
may  become  in  this  respect,  as  we  now  really 
are  in  many,  an  example  for  the  whole  civil- 
ized world.  Let  us  try  and  see-  We  are  of 
noble  descent,  and  our  liberal  government 
and  institutions  should  improve  us,  not  make 
us  worse. 

But  I  must  pass  on,  in  conclusion,  to  a  mere 
glance  at  a  few  of  the  American  hospitals, 
only  referring  to  those  with  which  I  am  some- 
what acquainted. 

American  Hospitals. 

It  would  require  a  volume  to  describe,  even 
very  generally,  the  American  hospitals.  This 
I  will  not  attempt,  only  referring  to  the  few 
with  which  I  have  become  most  acquainted 
during  the  past  twenty  years;  that  I  may  be 
able  to  draw  a  comparison  between  our  own 
and  those  abroad,  etc.  I  will  therefore  only 
mention  the  Buffalo  Hospital,  of  Buffalo,  N. 
Y.;  the  Utica  Lunatic  Asylum,  of  Utiea.;  the 
hospitals  of  Montreal  and  Quebec;  and,  finally, 


62 

the  hospitals  of  New   York,  Brooklyn,  and 
Philadelphia. 

Buffalo  Hospital. 
The  hospital  of  the  Sisters  of  Charity  of 
Buffalo,  N.  Y.,  though  not  very  extensive,  is 
well  situated,  arranged,  and  conducted.  I 
was  there  a  few  years  since,  when  cholera  was 
raging  so  fearfully,  and  shall  never  cease  to 
respect  the  noble  women  who  bestowed  such 
unwearied  care  upon  the  poor  sufferers;  many 
of  whom  were  suddenly  smitten  down,  and 
brought  in  from  the  streets  on  planks  in  a 
state  of  collapse.  I  became  satisfied  also  that 
the  medical  attendance  there  is  good. 

JJtica  Lunatic  Asylum. 
The  lunatic  asylum  at  Utica,  N.  Y.,  is  an 
honor  to  the  noble  Empire  State,  being  well 
situated,  arranged,  and  constructed,  for  heat- 
ing, ventilation,  and,  in  fact,  everything  for 
which  it  was  designed.  It  has  large  accom- 
modations, and  from  all  I  have  been  able  to 
discover,  I  incline  to  the  opinion  that  the 
course  of  treatment  adopted  there,  and  the 
measure  of  success,  may  be  regarded  as  compar- 
ing favorably  with  the  great  Kichmond  District 
Lunatic  Asylum  of  Publin,  under  the  excel- 


63 

lent  management  of  Dr.  Lalor,  to  whom  I 
have  already  referred.  Dr.  Lalor  informed 
me  that  his  physical  treatment  consists  mainly 
in  correcting  whatever  deviation  he  could 
discover  in  the  system  from  the  standard  of 
health.  And,  I  believe,  the  same  rational, 
common-sense  course  of  treatment  is  generally 
pursued  by  Dr.  Gray  and  others  of  the  Utica 
Lunatic  Asylum. 

I  may  very  properly  mention,  in  this  con- 
nection, Brigham  Hall,  an  excellent  private 
asylum  for  the  insane,  well  situated  near  Ca- 
nandaigua,  N.  Y.,  founded  and  ably  conducted 
by  my  friend.  Dr.  Cook,  formerly  of  the 
Utica  Lunatic  Asylum. 

Montreal  and  Quebec  Hospitals. 

The  hospitals  of  Montreal  and  Quebec  which 
I  visited  a  f jw  years  since,  did  not  impress 
me  with  anything  very  especially,  except  the 
great  number  of  small-pox  cases  and  the  very 
few  of  tubercular  phthisis  they  contained; 
the  latter  circumstaDce  fully  satisfying  me, 
and  as  I  think,  justifying  the  belief  that  the 
colder  region  of  Car-acla,  with  a  dry  and 
highly  electric  atmcsphere,  is  a  partial  secu- 
rity against  tubercular  phthisis,  and  probably 


64 

tuberculous  diseases  in  general,  to  sucli  as 
may  reside  there.  I  should  add,  however, 
that  these  hospitals  are  very  well  arranged 
and  conducted,  as  appeared  to  me;  and  the 
physicians  were  kind  and  polite,  being  British 
Americans 

New  Yorh  and  Broohhjn  Hoqntals. 

The  hospitals  of  New  York  and  Brooklyn 
need  no  comment  from  me.  They  are  numer- 
ous, capacious,  well  cocducted,  and  generally 
quite  well  situated  and  arranged;  and  some 
of  them  remarkably  so.  Bellevue  and  others, 
might  pass  for  excellent  hospitals  anywhere. 
And  I  need  not  state,  what  everybody  knows, 
or  should  know,  that  the  New  York  and  Brook- 
lyn hospitals  are  conducted  by  no  ordinary 
men.  This  is  apparent  when  we  find  such, 
names  as  Parker,  Draper,  Wood,  Met- 
calfe, Hamilton,  Thomas,  Flint,  Van 
BuREN,  MoTT,  Sayre,  and  others,  too  numer- 
ous to  mention. 

Philadeljjliia  Hospitals. 

Finally,  last  but  not  least,  are  the  hos- 
pitals of  Philadelphia.  The  hospitals  of  this 
city  were  amoog  the  first  with  which  I  be- 
came acquainted  wbcn  a  student  twenty- five 


G5 

years  ago,  and  I  have  occasionally  visited  them 
since  tit  different  times;  nearly  all  of  them 
during  the  past  few  months.  And  while 
there  are  many  improvements  that  might  still 
be  made,  it  is  my  opinion  that  the  hospitals  of 
Philadelphia  are  as  good  in  every  essential 
particular,  as  the  average  of  hospitals  at  home 
and  abroad,  if  not  better. 

And  I  am  compelled  to  say,  that  while  I 
regard  the  Blochley  as  an  excellent  hospital, 
and  the  surgical  treatment  in  the  Pennsylvania 
Hospital  as  superior  to  that  of  any  other  hos- 
pital I  have  ever  seen,  the  New  Episcopal  Hos- 
pital^ in  the  northern  part  of  this  city,  with 
its  ten  acres  of  ground,  and  modeled  after 
the  Lariboisiere  in  Paris,  is  in  my  opinion, 
taking  everything  into  account,  the  best  hos- 
pital I  have  seen  in  this  country,  and  I  think 
I  may  say  anywhere.  Its  residents,  too,  are 
gentlemen.  And  though  most  of  the  physi- 
cians and  suT"geor!S  connected  with  the  Phila- 
delphia hospitals  appear  to  be  young  men, 
they  are  evidently  generally  efficient;  and 
Philadelphia  may  really  be  regarded  as  second 
to  no  other  eity  in  the  ability  of  its  physi- 
cians and  surgeons,  as  is  apparent  when  we 
call  to  mind  its  Giioss,  Wood,  Dunglison, 


66 

Hodge,  Meigs,  Jackson,  Dickson,  Rogers, 
the  two  Smiths,  Stillg,  Pancoast,  G-er- 
HARD,  Wallace,  Rand,  Biddle,  Agnew,  Da 
Costa,  etc.,  des-^rvedly  renowned  everywhere. 

Conclusion. 

Now,  iij  conclusion,  I  will  only  add,  that 
as  people  do  not  generally  get  sick  in  hospi- 
tals, it  may  be  thought  by  some  that  their 
situation,  surroundings,  drainage,  ventilation, 
etc.,  can  be  of  little  account.  It  should  be 
remembered,  however,  that  the  causes  of  this 
character  that  may  operate,  away  from  hospi- 
tals, to  produce  sickness,  operating  in  and 
about  them,  tend  to  keep  from  convalescence 
those  in  hospitals  thus  unfavorably  situated. 

While,  again,  the  difference  in  the  charac- 
ter of  disease  between  Canada  and  Philadel- 
phia in  America,  and  between  Scotland  and 
France  in  Europe,  may,  and  doubtless  does 
depend  very  much  on  the  difference  of  cli- 
mate; various  other  influences  have  import- 
ant bearings  in  varying  the  character  of  dis- 
ease in  these  various  countries  and  localities. 
It  is  my  opinion,  from  all  I  have  been  able  to 
observe,  that  the  similarity  of  disease  in 
Francs  and  the  United    States    of  America 


67 

may  be  owing,  in  part,  to  similarity  of  cli- 
mate ;  but  very  much  also  to  like  habits ;  the 
American  and  French  people  being,  as  it  ap- 
pears to  me,  very  much  alike  in  their  habits 
of  eating,  drinking,  exercise,  etc.,  the  vari- 
ous irregularities  too  common  to  us  and  them, 
predisposing  at  least  to  g astro-intestinal  dis- 
ease, including,  in  my  opinion,  enteric  fever; 
while,  on  the  other  hand,  the  English,  Scotch, 
Welsh  and  Irish,  taking,  as  I  think  they  do, 
plainer  food  with  greater  regularity,  are  hss 
predisposed  to  gastro-intestinal  diseases,  and 
hence  generally  get  tj/jjhus  instead  of  enteric 
fever  J  as  we  have  seen. 

The  damp  and  consequently  low  electrical 
state  of  the  atmosphere  in  the  British  Islands 
may  also  aid  in  producing  the  typhous  ten- 
dency there,  and  in  causing  the  passive  or 
asthenic  character  of  their  inflammatory  af- 
fections. It  doubtless  also  favors  the  scrofu- 
lous or  tuberculous  tendency  as  well  a^  devel- 
opment of  ophthalmic  and  cutaneous  affections 
so  common  there.  On  the  other  hand,  the 
comparatively  dry,  and  therefore  highly  eiec- 
iric  state  of  the  atmosphere  of  Canada  in 
America,  may  very  likely  account  mainly  for 
the    infrequency   of    tubercular    phthisis   in 


68 

Canada,  when  compared  with  the  British 
Islands,  France,  and  the  central  portions  of 
the  United  States,  as  we  have  seen  is  the 
case.  While,  again,  in  the  malarious  re- 
gions of  the  south-west  cf  the  United  States, 
it  is  very  possible  that  the  frequency  of  he- 
patic or  bilious  affections  may  les?en  in  those 
regions  tubercular  phthisis,  the  hepatic  affec- 
tions lessening  very  likely  the  pulmonary,  on 
the  ground  of  counter  irritation  or  attention, 
as  is  generally  supposed. 

Finally,  all  the  various  putrid  fevers  and  af- 
fections depending  upon  animal  and  contagious 
miasms,  as  cholera,  diphtheria,  spotted,  perni- 
cious, and  typhus  fevers,  etc.;  though  often  com- 
municated by  contagion,  may  be  and  frequently 
are  produced  directly,  and  also  rendered  very 
much  more  general  and  malignarjt  by  a  dis- 
regard, by  the  people,  of  proper  hygienic  rules j 
personal  and  public.  And  as  this  is  true  in 
relation  to  mcst  diseases  in  all  parts  of  the 
world,  and  as  most,  if  not  all  of  the  natural 
causes  of  disease,  as  electrical,  climatic,  etc., 
would  doubtless  cease  to  be  so  especially  in- 
jurious, were  the  laws  of  health,  including 
personal  and  public  hygiene,  obeyed  as  they 
should  and   might  be;  not  only  in  relation  to 


69 

hospitals,  but  as  regards  all  t^e  habits  and 
customs  of  individuals  and  communities  con- 
stituting cities,  states,  and  nations;  we  have 
a  right  to  conclude,  that  very  much  of  the 
sickness  and  consequent  suffering  of  the  hu- 
man family,  might  be  avoided,  by  a  rigid 
observance  of  these  laws.  The  laws  of  per- 
sonal and  public  hygiene,  then,  should  be  en- 
forced in  fownSf  cities  J  nations,  and  internation' 
ally  hy  quarantine,  as  anti-suicidal,  and  with 
as  much  rigor,  as  laws  for  the  prevention  of 
any  capital  crime,  tending  to  destroy  human 
life  and  health. 


A  GLANCE  AT   THE   BRITISH  ISLANDS, 
FRANCE,  AND  AMERICA, 

Ethiological,  Climatic,  and  General,  etc. 
Part  II. 


Having  made  a  tour  through  Scotland, 
England,  Wales,  Ireland,  and  France,  for 
medical  observation,  and  as  a  delegate  to  the 
International  Medical  Congress  in  Paris;  and 
also  to  attend  the  British  Medical  Association 
in  Dublin;  visiting  the  hospitals  of  Greenock, 
Glasgow,  Edinburgh,  London,  Paris,  Liver- 
pool, and  Dublin;  seeing  in  the  aggregate 
many  thousand  patients,  it  is  quite  natural 
that  my  professional  observations  should  have 
occupied,  more  especially,  my  earnest  attention. 

As,  however,  landing  at  Glasgow,  going  to 
the  highlands  up  Loch  Lomond  as  far  as  the 
Falls  of  Inversneid ;  and  from  Glasgow  to  Ed- 

C'l) 


72 

inburgh;  and  from  thence  cast,  througli  the 
^'  Garden  of  Scotland/'  to  the  North  Sea;  and 
then  south  to  and  through  the  east  cf  Eng- 
land, near  four  hundred  miles,  to  London, 
going  to  AVindsor,  Sydenham,  etc.,  and  from 
London  through  the  south-west  of  England, 
and  the  north-west  of  France,  by  Dieppe,  and 
Rouen,  through  Normandy  to  Paris,  going  to 
St.  Cloud,  Versailles,  etc.,  and  attending  the 
Great  Exposition ;  and  from  Paris  through  the 
north-east  of  France  and  south-east  of  England, 
by  Boulogne  and  Falkcstone,  back  to  London, 
from  thence  through  the  west  of  England  to 
Liverpool ;  and  from  Liverpool  through  Wales 
to  Holyhead,  and  by  the  Irish  Sea  to  Kings- 
ton, and  thence  by  rail  to  Dublin,  where  I  at- 
tended the  British  Medical  Association ;  and 
from  Dublin,  finally,  by  rail,  near  two  hundred 
miles,  through  to  the  north  of  Ireland,  by 
Londonderry  to  Movile,  where  I  took  ship  for 
America,  I  could  not  do  less  than  make  a  gen- 
eral observation  of  the  country,  towns  and  peo- 
ple on  my  way. 

It  is,  then,  only  my  general  observations  of 
the  country,  including  Scotland,  England, 
Wales,  Ireland,  and  France ;  of  their  chief 
towns,  including  Glasgow,  Edinburgh,  London, 


i6 

Liverpool,  Holyhead,  Dublin  and  Paris;  and 
of  i\Q  people,  including  the  Scotch,  English, 
Welsh,  Irish  and  French,  that  I  propose  to 
speak,  and  in  the  order  in  which  I  have 
named  them;  purposely  avoiding  all  minutia 
of  detail ;  but  striving  to  give  such  informa- 
tion, ethnological  J  climatic,  and  general,  as  may 
be  of  interest,  and  closing  with  a  general 
glance  at  America,  Americans,  etc. 

Scotland  and  the  Scotch. 

Scotland,  lying  between  the  Atlantic  Ocean 
and  the  North  Sea,  nearly  north  of  England 
and  Wales,  and  to  the  north-east  of  Ireland ; 
being  some  three  hundred  miles  in  extent 
north  and  south,  and  from  one  to  two  hundred 
east  and  west ;  has  many  small  rivers  and  bays, 
being  also  surrounded  by  numerous  islands, 
some  of  which  are  to  the  west  of  the  main- 
land in  the  Atlantic,  while  others  are  in  the 
North  Sea,  to  the  north-east,  producing  a  va- 
riety of  sea  coast  surpassingly  romantic,  and 
grand  in  the  extreme. 

The  general  face  of  the  country,  though 
rough  in  many  places,  is  by  no  means  repul- 
sive, presenting  a  variety,  from  the  beautiful 
level  fertile  region,  called  the  *' Garden  of 
7* 


74 

Scotland/'  to  the  rugged  highlands,  covered 
with  heather,  their  lofty  peaks,  in  some  in- 
stances, being  lost  in  the  clouds,  presenting 
all  the  grandeur  that  such  lofty  mountains,  in- 
terspersed with  beautiful  lakes  can  afford  to 
the  human  eye;  and  especially,  being  asso- 
ciated as  they  are,  with  the  wild  romantic  his- 
tory of  more  than  twenty  centuries  of  the  past. 
The  highlands  of  the  west  and  north-west 
of  the  island,  are  but  slightly  productive,  es- 
pecially the  higher  portions,  producing  little 
more  than  the  heather,  and  a  variety  of  graFs, 
which  serve  as  food  for  the  small  highland 
sheep,  that  sport  amidst  these  luxuries  to  them, 
upon  their  native  hills ;  appearing  in  the  dis- 
tance, like  small  white  specks  on  the  moun- 
tain sides,  and  knowing  well  the  voice  of  their 
shepherd,  as  he  ascends  from  his  neat,  but 
often  rude  cottage,  in  the  vale  beneath.  One 
of  those  cottages  was  pointed  out  to  me  by  a 
lady,  in  which,  her  grandmother  lived  and 
died,  having  never  been  a  mile  from  the  place 
of  her  birth.  It  was  near  Loch  Lomond,  and 
in  sight  cf  Ben  Lomond's  lofty  peak,  where 
even  a  sage  philosopher  might  consistently 
thus  have  lived  and  died,  if  there  is  such  a 
place,  anywhere. 


75 

The  south  and  south-east  portions  of  the 
country  being  quite  level,  have  a  more  pro- 
ductive or  fertile  soil;  producing  wheat,  oats, 
barley,  peas,  beans,  and  good  meadow  and  pas- 
ture; being  a  fine  agricultural  region;  having 
large  herds  of  cattle,  sheep,  and  other  domestic 
animals.  The  farm  liouses  are  generally  of 
stone,  with  slate  roofs.  The  fences  are  mostly 
hedge,  and  the  forests  consist  of,  or  are  inter- 
spersed with,  the  beautiful  Scotch  pine,  the  tree 
so  much  a'jmired  as  an  ornament  for  yards 
in  our  own  country ;  flourishing  in  great  luxu- 
riance and  beauty,  in  its  native  soil ;  giving 
even  the  woods,  a  bright  and  lovely  appear- 
ance, and  aifording  the  wild  songsters,  a  tem- 
ple of  rare  beauty,  in  which  to  sound  their 
notes  of  praise,  to  the  common  Parent  of  all. 

Scotland,  then,  including  all  its  parts,  of 
high  and  low  lands;  with  its  romantic  ''sea- 
girt shores,''  is  a  rich,  beautiful,  and  grandly 
romantic  country,  with  a  great  variety  of 
scenery,  soil,  and  productions;  being  capable 
of  supporting  as  it  really  does,  a  dense  popu- 
lation; the  variety  of  its  natural  scenery,  by 
far  surpassing  that  of  any  country  with  which 
I  am  acquainted,  considering  its  limited  extent, 
and  its  aLnio>ph€rcj  though  somewhat  damp,  is 


delightful;  the  unevenncss  of  its  surface  in- 
terrupting or  lessening  very  mucli  the  preva- 
lence of  heavy  winds;  and  while  its  summers 
are  cool,  its  winters  are  rendered  quite  mild, 
by  its  oceanic  surroundings. 

Cliic'f  Towns. 

The  principal  cities  of  Scotland  that  I  shall 
mention,  are  Cllasgow  and  Edinburgh,  as  best 
calculated  to  illustrate  the  character  of  Scotch 
towns. 

GlasgrAc  is  situated  in  the  west  of  Scot- 
land, oa  the  River  Clyde,  at  the  point  where 
it  becomes  navigable;  being  surrounded  by 
the  Campsie  and  Kilpatric  hills,  on  the  north, 
north-east  and  north-west;  and  occupying  au 
elevation  well  calculated  for  the  site  of  a  large 
commercial  city. 

It  is  a  manufacturing  town,  having  a  popu- 
lation of  nearly  five  hundred  thousand,  446, 
639,  in  1867 ;  and  being  quite  ancient,  it  is 
somewhat  irregularly  laid  out,  especially  the 
older  parts.  The  streets  are  also,  in  some 
places  crooked,  and  rather  narrow.  The 
newer  portions,  however,  are  fine;  the  streets 
and  parks  presenting  an  air  of  grandeur;  the 
houses  being  c  )nstructcd  of  fine  stone,  with 


/  i 

s^ate  roofs;  embracing  Blytliswood  Square, 
Woodside  Place  and  Crescent,  West  End  Park 
region,  etc. 

Glasgow  has  some  ancient  structures  of 
great  interest,  architectural  and  historical  j 
among  which,  perhcaps,  the  most  prominent, 
are  the  Cathedral  of  the  twelfth  century,  and 
the  University  of  Glasgow,  several  hundred 
years  old,  about  to  be  removed  to  the  vicinity 
of  West  End  Park.  And  besides,  it  has  many 
modern  buildings  of  great  beauty,  as  the  Post 
Office,  Royal  Exchange,  etc.,  as  well  as  statu- 
ary, parks,  bridges,  and  fountains,  of  more  or 
less  beauty.  The  city  has  two  Medical  Uni- 
versities, the  Royal  Infirmary,  containing  four 
or  five  hundred  patients,  an  extensive  Eye  In- 
firmary, a  Dispensary  for  Diseases  of  the  Skin  ; 
and  various  other  minor  institutions,  of  a  kin- 
dred character,  where  the  infirm  poor  are 
abundantly  provided  for,  all  of  which  are  well 
managed. 

The  inhabitants  of  this,  which  is  the 
largest,  and  one  of  the  oldest  cities  of  Scot- 
land, are  mainly  Scotch,  with  a  few  Irish,  and 
a  sprinkling  of  other  nationalities.  Its  cli- 
7nafe  is  temperate,  but  on  account  of  the  sur- 
rounding hills  the  atmosphere  is  rather  humid, 


78 

and  coDScqiiently,  not  very  highly  electric, 
predisposing  the  inhabitants,  more  or  less,  to 
ophthalmia,  cutanecus,  scrofulous,  and  tuber- 
culous affpctioDs,  etc.,  especially  in  its  most 
crowded  parts,  as  I  noticed.  Hence,  also,  the 
prevalence  of  typhtis  fever  here,  at  times. 
Glasgow  is  probably  as  healthy,  however,  as 
most  cities  of  its  size,  anywhere;  paludal  dis- 
eases, being  scarcely,  if  at  all,  known  there. 

Edinhurcjh,  situated  in  the  eastern  part  of 
Scotland,  near  the  Firth  of  Forth,  on  the 
North  Sea,  is  a  romantic  old  town,  having  a 
population  of  over  two  hundred  thousand, 
201,748  in  1866,  including  Leith.  It  consists 
of  the  old  and  new  portions;  the  former  of 
which  has  for  its  centre  Castle  Hill,  being  383 
feet  high.  The  other  eminences,  consisting 
of  Arthur's  Seat  and  Salisbury's  Crags,  are 
in  the  distance,  a  little  out  of  the  city,  and 
near  Holyrood  Palace,  presenting  a  mcst 
wildly  grand  and  romantic  appearance.  All 
these,  together  with  the  various  monuments, 
the  roughness  of  the  old,  and  grandeur  of  the 
new  parts  of  the  city,  with  its  fine  brown- 
stone  houses  with  slate  roofs,  may  be  regarded 
as  constituting  the  ''modern  Athens/' in  many 
respects,  as  it  has  been  styled. 


70 

Aside  from  tlie  elevations  already  named, 
the  site,  thougli  somewhat  broken,  is  by  no 
means  an  unpleasant  one;  consisting  of  two 
ridges  divided  by  a  ravine,  allowing  a  quiet 
passage  for  the  North  British  Hailway,  at 
the  foot  of  Castle  Hill,  between  the  old 
and  new  portions  of  the  town;  the  Firth  of 
Forth  ap-pearing  in  the  distance,  to  the  north- 
east. 

The  principal  objects  of  interest  in  this 
grand  old  city  of  the  Scottish  kings,  are  the 
Barracks  on  Castle  Hill,  wherein  Queen  Mary 
gave  birth  to  James  the  vSixth,  in  whom  were 
united  the  Crowns  of  Scotland  and  England; 
the  Palace  of  Holyrood,  from  whence  the  un- 
fortunate Queen  was  taken,  imprisoned,  and 
finally  compelled  to  abdicate  in  favor  of  her 
infant  son;  John  Knox's  House,  with  a 
projection  in  front,  from  which  the  great  re- 
former so  effectually  preached  to  the  passers 
by,  never  failing  to  reprove  and  exhort  to 
repentance  and  reform  all  ranks,  the  high  as 
well  as  the  low;  and  the  University  of  Edin- 
burgh, which,  springing  up  in  the  early  his- 
tory of  Scottish  civilization,  has  become,  as 
it  were,  "the  light  of  the  world,^'  in  every- 
thing pertaining  to  law,  medicine,  divinity, 


80 

ami  the  arts,  with  its  library  of  one  hundred 
and  thirty-three  thousand  printed  books. 

And  besides,  Edinburgh  has  a  Botanical 
Garden,  with  a  Palm-House  one  hundred  feet 
high;  the  Antiquarian  3Iuseumj  the  National 
Gallery;  the  Museum  of  Science  and  Art; 
and  the  Anatomical  Museum  of  Sir  Charles 
Bell;  all  of  which  contain  a  variety  of  ob- 
jects in  their  several  departments,  of  sur- 
passing interest,  enough  to  occupy  an  active 
mind  for  a  long  time  in  the  examination. 

Finally,  Edinburgh  has  the  Eoyal  Infirm- 
ary, accommodating  several  hundred  patients; 
Chal:>ier's  Hospital,  of  less  dimensions;  and 
various  others  that  I'  need  not  mention,  afford- 
ing abundant  accommodations  for  the  infirm 
poor  of  this  grand  old  city.  Its  position,  near 
the  Sea,  with  comparatively  level  surround- 
ings for  many  miles,  except  the  elevations 
named,  may  account  for  the  fact  that  less 
scrofulous,  cutaneous,  and  ophthalmic  afi"ec- 
tions  are  found  here  than  in  Glasgow,  as  ap- 
peared to  me.  And  though  Edinburgh,  from 
its  situation,  is  more  or  less  subject  to  high 
winds,  and  has  a  slightly  humid  atmosphere, 
in  common  with  other  British  towns;  giving 
disease  there  a  typhous  tendency;  palndnl  dis- 


81 

eases  are  almost  entirely  unknown  tliere,  as 
in  Glasgow. 

But  I  must  pass  on  from  a  consideration  of 
the  country  and  its  towns,  to  the  inhabitants. 

The  Scotch  People. 

Descendants,  as  they  are,  of  the  ancient 
Celts,  or  wild  men  inhabiting  the  coverts  in 
the  forests  of  the  British  Islands  and  the  west 
of  Europe,  as  the  very  name  implies;  with  a 
mixture  of  Roman,  Danish,  Saxon,  and  Nor- 
man blood,  in  a  limited  and  variable  degree ; 
emerging  from  a  state  of  semi-barbarism  amidst 
the  beauties  and  ''handy  work"  of  nature 
constituting  their  native  wilds,  grand,  roman- 
tic; and  sublime  in  the  extreme;  we  find,  as 
might  be  expected,  a  hardy,  noble,  virtuous, 
manly,  industrious,  Grod-fearing  people  in  the 
Scotch.  In  short,  a  noble  specimen  of  hu- 
manity^  for  whom  the  human  race  may  well 
be  thankful. 

In  fact,  it  is  my  opinion,  that  the  Scotch,  as 
a  people,  have  more  qualities  that  it  would 
be  a  virtue  to  imitate,  than  any  other;  while, 
on  the  other  hand,  they  have  fewer  of  the 
vices.  I  must  be  pardoned  for  speaking 
thus  plainly  on  this  subject,  as  I  am  only 
8 


82 

littering  convictions  that  have  been  forced 
upon  me.  Their  present  state  of  civilization 
has  been  arrived  at,  however,  after  the  reign, 
in  darkness,  as  it  were,  of  nearly  a  hundred 
kings,  from  a  period  long  anterior  to  the 
Christian  era;  the  people,  in  passing  from  a 
state  of  semi-barbarism  to  their  present  exalt- 
ed position  in  the  scale  of  civilization,  having 
passed  through,  as  is  customary  during  such 
a  transition,  many  scenes  of  confusion,  blood- 
shed, and  carnage,  at  which  even  humanity 
revolts. 

In  conclusion,  then,  I  would  remark,  that 
the  superiority  of  the  Scotch  character,  as  a 
whole,  may  be,  and  doubtless  is  owing  to  the 
circumstances  already  enumerated,  togefher 
with  others,  such  as  advantage  of  position 
and  climate,  the  mingling  of  races,  etc.,  all 
of  which  have  more  to  do  in  forming  even 
the  physical,  intellectual,  and  moral  character 
of  a  people  than  may  generally  be  supposed. 

England  and  the  English. 

England,  lying  between  Scotland  and  the 
English  Channel  north  and  south;  and 
bounded  east  by  the  North  sea;  and  on  the 
west  by  the  Atlantic,   Irish  Sea,  and  Irinh 


88 

Channel;  being  from  four  to  five  hundred 
miles  in  extent,  north  and  south,  and  nearly 
half  that  distance  east  and  west,  is  a  rich  and 
beautiful  country,  having  numerous  small 
rivers  and  slight  elevations,  but  not  enough 
to  break  the  general  even  appearance  of  the 
country. 

The  fertility  of  the  soil,  the  mildness  of  the 
climate,  and  its  level  surface,  together  with 
its  high  state  of  cultivation,  conspire  to  make 
England  one  of  the  richest  agricultural  coun- 
tries I  have  ever  seen ;  and  especially,  consid- 
ering the  centuries  of  time  it  has  been  under 
cultivation. 

The  climate^  though  mild  in  winter,  on 
account  of  its  oceanic  surroundings,  is  for  the 
same  and  other  reasons,  coolish  in  summer, 
and  somewhat  humid,  predisposing  to  scrofu- 
lous, tuberculous,  and  other  kindred  affections. 
And  while  its  atmosphere  doubtless  also  pre- 
disposes to  a  typhous  tendency  in  disease; 
paludal  affections  are  scarcely  known;  the 
system  of  drainage  having  removed  the  sources 
for  the  generation  of  marsh-miasm,  if  they 
ever  existed;  and  though  its  level  surface,  as 
well  as  its  surroundings,  may  render  England 
more  or  less  subject  to  high  winds;  the  ex- 


84 

trcmes  of  temperature,  are  not  as  groat  as  in 
most  countries  of  its  latitude. 

1\^  productions  are  wheat,  rye,  barley,  oats, 
peas,  beans,  hops,  roots,  etc.,  besides  furnishing 
excellent  meadow,  and  the  finest  pasture  I 
have  ever  seen,  thus  supporting  a  dense  popu- 
lation, and  supplying  food  for  an  immense 
herd  of  very  fine  sheep,  cattle,  a'nd  other  do- 
mestic animals.  In  fact,  the  vast  number  of 
sheep  is  really  astonishing,  especially  along 
the  eastern  portion  of  the  island,  bordering  on 
the  North  Sea. 

The  fields  are  beautifully  surrounded  and 
divided  by  hedge^  which,  being  generally 
kept  in  a  fine  condition,  gives  the  whole  face 
of  the  country  a  very  pleasant  appearance ;  in 
some  places,  as  about  London,  appearing  not 
unlike  a  beautiful  and  extended  garden,  being 
covered,  in  the  season  for  them,  with  fruit 
and  vegetables  in  abundance. 

If  we  except  the  mountains  of  Wales,  how- 
ever, England  has  not  that  variety  of  surface 
and  scenery,  which  is  calculated  to  inspire  the 
beholder  with  awe,  as  does  the  varied  scenery 
of  Scotland,  with  its  hills,  vales,  mountains, 
lakes,  etc.  In  fact,  nature  appears  to  have 
formed  this  pleasant  country,  with  a  view  to 


85 

awaken  in  the  beholder,  admiration,  not  awe- 
to  cause  the  mind  to  run  out  in  gratitude  to 
the  Creator,  for  its  vast  richness;  rather  than 
to  excite  those  stronger  emotions,  leading  to 
daring  deeds,  so  naturally  aroused  by  more 
wild  romantic  scenery.  And,  it  really  appears 
to  me,  that  the  mind  that  can  contemplate  this 
beautiful  country,  without  having  awakened 
feelings  of  high  admiration,  and  also  gratitude 
to  the  Creator,  must  be  defective,  morally,  if 
not  intellectually. 

CMef  Towns. 

England  has  a  large  number  of  towns  or 
cities,  the  most  important  of  which  are  Lon- 
don and  Liverpool )  the  former  in  the  south- 
eastern, and  the  latter  in  the  north-western 
part,  both  of  which  may  admit  of  a  brief  de- 
scription, as  we  pass  along,  as  better  illustrat- 
ing the  peculiarities  of  English  towns  than 
any  others. 

London^  situated  on  the  river  Thames, 
about  sixty  miles  from  the  North  Sea,  is  one 
of  the  oldest  cities  of  England,  having  been  a 
considerable  town  of  the  ancient  Britons,  long 
before  the  Roman  invasion ;  and  for  several 
centuries   before    the    Christian   era.     Com- 


86 

mencing  thus  early,  it  has  been  the  scene  of 
many  conflicts,  during  the  Roman,  Anglo- 
Saxon,  Danish  and  Norman  invasions  and 
conquests,  having  been  marred  but  not  de- 
stroyed, amidst  the  clash  of  arms  and  the 
wreck  of  empires. 

Thus  increasing  steadily,  during  more 
than  twenty  centuries  ;  it  has  now  an  area  of 
near  one  hundred  square  miles,  and  a  popula- 
tion of  about  three  millions  of  inhabitants. 
And,  notwithstanding  its  damp  and  smoky  at- 
mosphere, and  exterior,  generally,  London  has 
a  mine  of  wealth ;  many  magnificent  public 
and  private  buildings,  and  fine  parks,  churches, 
monuments,  bridges,  hospitals,  etc.,  calculated 
to  interest  the  thoughful,  and  to  inculcate  an 
appreciation  of  whatever  is  of  substantial  utili- 
ty, in  science,  arts,  religion,  etc. 

The  site  of  London  is  quite  level,  occupy- 
ing both  sides  of  the  Thames.  And  the  chief 
objects  of  interest  are,  the  Houses  of  Parlia- 
ment, St.  Paul's  Cathedral,  Buckingham  Pal- 
ace, the  Tower  of  London,  Westminster  Cha- 
pel and  Abbey,  and  the  various  bridges, 
hospitals,  museums,  etc.,  too  numerous  to 
mention.  The  Hunter  Museum  is  the  largest 
by  far,  that  I  have  ever  seen,  and  I  believe  it 
is  the  largest  in  the  world. 


87 

The  city,  being  divided  by  the  River 
Thames,  has  the  appearance  of  a  mighty 
village.  In  fact,  it  has  really  been  formed  by 
the  connecting  of  numerous  small  towns  grad- 
ually extending  till  they  have  met ;  the  dwell- 
ings, being  many  of  them  small,  contrasting 
strangely  with  the  magnificent  buildings  and 
structures  already  referred  to,  as  well  as  others 
too  numerous  to  mention. 

Finally,  London  is  a  great  commercial  city, 
its  docks  extending  several  miles  along  the 
Thames,  the  peaceful  bosom  of  which  bears 
the  mighty  ships  of  every  sea  and  naviga- 
ble river  in  the  whole  habitable  globe.  And, 
though  the  atmosphere  of  London  is  damp, 
retaining  much  of  the  smoke,  which,  hanging 
over  the  city,  often  gives  it  a  dark  and  gloomy 
appearance;  and  also  predisposes  its  inhabi- 
tants to  the  diseases  common  to  the  British 
Islands,  already  referred  to;  I  was  astonished 
at  the  apparent  degree  of  health  enjoyed  by 
its  people.  They  take,  however,  good,  plain, 
substantial,  nourishing  food,  and  generally 
with  regularity;  as  beef,  mutton,  bread,  eggs, 
milk,  etc.;  all  tending  to  counteract  the  de- 
pressing effect  of  a  humid  smoky  atmosphere, 
saturated,  more  or  less,  of  course,  with  animal 


88 

miasms,  the  paludal  having  scarcely  an   ex- 
istence there. 

The  suhurhan  toicns  and  objects  of  interest 
about    London   are   very   numerous;    among 
which   are,  the  Crystal  Palace,  near  Syden- 
ham,  about  seven   miles  south  of  the  city, 
constructed  at  a  cost  of  one  million  five  hun- 
dred   thousand   pounds    sterling,    containing 
much  to   interest,   with   its    gardens,    parks, 
fountains,  etc.     Down  the  Thames  are,  Green- 
wich, with  its  Hospital,  Park  of  two  hundred 
acres,   and    Royal    Observatory,    founded   by 
George  III.  for  the  promotion  of  astronomi- 
cal science;  Woolwich,  etc.     Up  the    river, 
again,  are  Kew,  with  its  Botanic  Garden  and 
Palm- House,  sixty  feet  high ;  Richmond,  nine 
miles    up,   with  its  beautiful  terraced    hills; 
Hampton,  thirteen  miles,  with  its  fine  Green, 
and  graced  by  Hampton  Court  Palace,  situated 
in  a  garden   near  the  Thames;  and,  finally, 
"Windsor,  twenty-two    miles    above   the  city, 
having   a  fine    elevation,  upon   which   stand 
Windsor  Palace  and  Castle,  from  the  tower  of 
which  may  be  seen  St.  George's  Chapel,  where 
Her  Majesty,  the  Queen,  attends  service  when 
there,  and  also  a  small  church   eleven  hun- 
dred years  old,  the  Royal  Walk,  three  miles 


89 

long,  at  tbo  end  of  which  ftatids  the  statue  of 
George  III.,  the  Ptoyal  Park,  where  repose 
the  remains  of  Prince  Albert,  the  site  of 
the  oak  where  King  John  signed  the  Magna 
Charta,  Admiral  Penn's  old  residence,  the 
site  of  Anne  Page's  house,  and  other  places 
referred  to  in  Shakespeare's  "  Merry  Wives 
of  Windsor,"  as  the  site  of  Heme's  Oak,  of 
Falstaif  notoriety,  and  the  place  near  by  in  the 
Thames,  where  that  dignitary  is  represented 
as  having  got  his  unceremonious  hath,  all  so 
graphically  set  forth  by  the  great  poet;  all 
places  and  objects  well  repaying  an  attentive 
observation,  on  account  of  their  intrinsic 
beauty  as  well  as  historic  interest. 

All  the  above  towns  and  situations,  except 
one  or  two  down  the  Thames,  are  clean,  airy, 
and  delightful,  and  well  calculated  to  promote 
health,  as  well  as  to  enliven  the  intellectual 
and  improve  the  moral  powers  of  the  inhabi- 
tants and  beholder.  But  I  must  leave  this 
mighty  old  city  and  its  surroundings,  and 
pass  on  to  a  consideration  of  Liverpool,  which 
is  situated  on  the  Irish  Sea,  in  the  northwest 
part  of  England,  as  is  well  known. 

Liverpool  is  a  great  commercial  town,  hav- 
ing a  rapidly  increasing   population  of  near 


90 

two  hundred  thousand;  its  Docks  hoing  on  a 
large  scale  and  very  fine.  This  city  is  on  an 
eminence,  and  admirably  calculated,  from  all 
its  surroundings,  for  a  great  commercial  town. 
It  has  many  fine  buildings,  and  may  yet  be- 
come a  mighty  city,  somewhat  ximerican  in 
its  character,  as  it  really  is  already,  on  ac- 
count, in  part,  of  the  immense  amount  of 
American  shipping  and  number  of  American 
seaman  constantly  there. 

Liverpool  has  an  Infirmary,  accommodating 
several  hundred  patients,  and  its  poor  are  as 
well  cared  for,  probably,  as  in  most  other 
cities  of  its  size,  if  we  except  perhaps  Lon- 
don, with  its  hospital  accommodations  for  many 
thousand  patients,  admirably  arranged  and 
conducted.  The  somewhat  elevated  site  of 
Liverpool,  together  with  its  position  by  the 
sea,  making  it  more  or  less  liable  to  winds, 
may  account  for  its  less  foggy  and  smoky  at- 
mosphere than  that  of  London.  Its  atmos- 
phere, however,  is  more  or  less  humid,  which, 
together  with  the  animal-miasm  necessarily 
generated  to  some  extent  in  a  crowded  com- 
mercial town,  may  account  for  the  fact,  which 
was  quite  apparent  to  me,  that  Liverpool  is 
more  predL«posed   to  low  putrid   disease   than 


91 

London.  Paludal  diseases  are  not,  I  think, 
endemic  there  to  any  considerable  extent; 
if  they  even  prevail  at  all,  except  imported 
cases. 

But  I  must  leave  the  consideration  of  Eng- 
land with  its  chief  towns,  and  pass  on  to 
notice  its  inhabitants. 

The  English  People. 

The  English  are  evidently  descendants  of 
the  same  original  Celtic  stock  as  the  Scotch; 
but  much  more  modified  by  the  mingling  of 
the  Roman,  Anglo-Saxon,  and  Norman  blood 
than  they;  with  less  of  the  Danish  or  Scandi- 
navian; the  country  having  been  invaded, 
and  either  partially  or  entirely  subdued,  in 
turn,  by  the  Romans,  G-ermans  or  Saxons,  the 
the  Danes  or  Norwegians,  and  finally  by  the 
Normans  of  France;  mingling  more  exten- 
sively, however,  with  the  ancient  Celtic  stock, 
the  Roman,  Saxon,  and  Norman  blood,  than 
others,  as  would  appear. 

The  English  people,  then,  thus  originating 
and  modified,  have  emerged  from  a  state  of 
semi-barbarism,  during  the  past  twenty  cen- 
turies, under  circumstances  of  a  varied  char- 
aoter,  their  rich  fertile  country  having  been 


92 

tlic  object  for  invasion  by  the  surrounding 
nations,  or  people,  more  civilized,  in  some 
instances,  than  themselves;  thus  directly  caus- 
ing their  customs,  manners,  and  even  religion, 
to  be  greatly  modified,  in  some  instances,  and 
especially  their  language. 

The  Anglo-Saxons,  then,  thus  springing 
up  in  the  English  character,  inhabiting  a 
delightful,  rich,  and  fertile  region,  have 
emerged  from  a  state  of  semi-barbarism  to 
their  present  condition  of  civilization,  influ- 
enced by  less  romantic,  but  perhaps  a  greater 
number  of  extrinsic  circumstances,  than  those 
that  surrounded  and  influenced  the  Scotch. 
These  circumstances,  together  with  the  greater 
mingling  of  the  Roman,  Saxon  and  Norman 
blood,  with  perhaps  less  of  the  Danish  or 
Scandinavian  than  the  Scotch,  together  with 
the  difference  of  position,  climate,  etc.,  must 
account  for  the  difference  between  the  Eng- 
lish and  Scotch  of  the  present  day. 

The  English  people,  thus  favorably  situ- 
ated, and  quite  powerful,  when  compared  with 
the  Scotch  and  Irish,  may  possibly  have  a 
more  lofty  disposition;  in  some  instances,  per- 
haps, tending  to  excess.  And  this  is  just 
what  might  be  expected  to  remain  with  any 


m 

people,  in  their  transition  from  semi- barbarism 
to  civilisation,  under  sach  circumstances; 
and,  especially,  as  civilization  is  the  work  of 
circumstances.  And  if  the  English  do  retain 
an  undue  degree  of  a  lofty  spirit,  it  is  because 
that  element  of  their  earlier  civilisation  has 
not  been  thoroughly  eradicated  by  the  cir- 
cumstances with  which  they  have  been  sur- 
rounded. The  former  system  of  education, 
too,  in  England,  together  with  the  law  of  pri- 
mogeniture, confining  the  wealth  and  educa- 
tion, more  especially  to  the  few,  to  the  neglect 
of  the  masses,  may  have  hindered,  in  some 
degree,  its  eradication. 

With  this  slight  defect,  if  it  may  be  re- 
garded as  such,  in  English  civilization,  for 
which,  as  we  have  seen,  they  are  in  nowise 
responsible,  the  English  are  a  noble,  gener- 
ous, kind,  benevolent,  sober,  thinking,  and 
decidedly  intellectual  people;  doing  much  for 
the  elevation  of  humanity,  and  the  spread  of 
Christianity  throughout  the  world;  speaking 
a  languagGj  that,  when  properly  modified,  en- 
riched, and  refined,  may  yet  become  the  lan- 
guage of  the  whole  civilized  world,  on  account, 
in  part,  of  their  extensive  con^iercial  relo,- 
iiofiB,  to-cthor  with  tKat  of  their  descendants 


M 

of  ttis  vast  Continent,  embracing  the  inliabi-* 
tants  of  the  British  possessions  in  America, 
and  of  the  United  States. 

It  is  probable  that  the  noble  characteristics  of 
the  English;  physical,  intellectual,  and  moral  ^ 
may  have  been  owing,  in  a  very  great  degree, 
to  the  mingling  of  blood  in  their  constitu- 
tions, as  well  as  to  the  modincation  of  their 
manners,  customs,  religion,  ets  ,  growing  out 
of  this  mingling  of  the  different  nationalities 
out  of  which  they  have  grown ;  to  which  may 
also  be  added  their  favorable  position  for  com-' 
mercial,  and  other  relations. 

But  I  must  proceed  to  a  consideration,  as 
we  pass,  of  the  Western  portion  of  this  Island 
and  its  inhabitants. 

Wales  and  the  Welsh. 

Wales,  occupying  a  amall  extent  of  country, 
to  the  West  of  England,  bordering  on  the 
Irish  sea  and  Channel,  is  a  mountainous  region, 
being  less  than  two  hundred  miles  in  extent 
north  and  south,  and  scarcely  balf  that  dis- 
tance east  and  west.  While  some  parts  of 
Wales  are  mountainous,  along  its  northern 
border,  upon^he  Irish  Sea,  the  surface  of  tha 
c-ountrv  iy  only  somcwhskt  broken  aud  liiliy. 


^5 

presenting  a  very  romantic  appearance;  and, 
in  some  places,  it  is  quite  level. 

Taken  as  a  wliole,  then,  Wales  is  a  fertile 
region  of  country,  having  a  fine  variety  of 
surface  and  scenery,  and  producing  wheat, 
rye,  oats,  barley,  potatoes,  beans,  peas,  and 
fine  meadow  and  pasture ;  sustaining  fine  cat- 
tle, sheep,  and  other  domestic  animals.  In 
fact,  the  general  appearance  of  the  country  is 
inviting  to  the  beholder,  rather  than  repulsive, 
and  well  calculated  to  produce  contentment, 
as  well  as  to  draw  out  the  mind  in  a(? miration, 
for  the  ^'hundy-work  of  nature,"  by  which 
the  beholder  is  surrounded,  leading  the  mind 
gently  and  adoringly,  ^'through  nature  up  to 
nature's  G^od." 

Such,  then,  is  Wales,  with  its  hills,  valleys, 
mountains,  bays  and  rivers ;  evidently  moulded 
by  the  hand  of  the  Creator,  to  lead  its  -inhabi- 
tants to  noble  deeds  of  daring  j  or  to  the  quiet 
pursuits  of  civilizid  life,  as  circamstance's 
might  require.  Its  atmosphere,  though 
slightly  humid,  is  less  so,  and  more  bracing 
than  in  other  and  more  level  portions  of  the 
island,  inhabited  by  their  more  numerous 
neighbors,  the  English.  And,  though  situa- 
ted along  the  Irish  Sea  and  Channel,  its  broken 


9G 

Furface,  must  render  it  less  liable  to.hcuvy  ani 
trying  winds. 

Chief  Towns. 

The  towns  of  Wales  are  not  numerous  or 
very  large;  I  will  only  speak  of  one,  Holy- 
liead,  a;nd  that  very  inconsiderable. 

Holyheadj  in  the  north-west  of  Wales,  on 
the  Irish  Sea,  is  a  small  town  of  some  little 
businesS;^  being  the  terminus  of  a  rail-road,  as 
well  as  the  port  to  and  from  which  steamers 
pass  for  Kingston  and  Dublin,  etc.  It  is  very 
much  exposed  to  the  sea  breeze,  rendering  it, 
as  would  appear,  a  very  healthy  situation.  It 
is  a  place  of  some  little  importaiice,  and  may 
yet  become  quite  a  town,  should  circumstan- 
ces favor  it. 

But  leaving  Wales  and  its  towns,  let  us  pass 
on  to  consider  its  inhabitants.  ' 

The  Welsh  People. 

In  the  Welsh,  we  have  an  illustration  of 
the  ancient  Britons,  of  the  pure  Celtic  stock; 
unmixed,  to  any  considerable  extent,  with 
other  races  of  men. 

And,  here  it  is  that  we  find  an  illastratioB 
of  the  pure  Celtic  people,  emerging  from  a 
state   of    semi-barbarism,    mainly    by    ^hdr 


07 

own  exertions;  influenced  more  or  less,  by  other 
races  of  men,  it  is  true;  but  mainly,  by  the 
scenery  of  their  native  hills  and  vales,  and 
other  intrinsic  circumstances ;  all  tending  to 
make  a  quiet,  peaceable,  virtuous,  God-fear- 
ing people;  zealous  for  the  right,  civil,  po- 
litical, and  religious ;  and  ready  for  any  reform 
calculated  to  improve  their  own  condition,  or 
that  of  their  fellow-creatures,  over  whom  their 
limited  influence  may  chance  to  be  exerted. 

Thug  we  have,  in  the  Welsh,  speaking 
their  own  Celtic  tongue,  in  the  main  un- 
changed, except  in  the  towns,  occupying  their 
own  native  hills,  which  have  echoed  to  their 
voices  for  more  than  twenty  centuries,  an 
example  of  noble  self-civilization,  retaining 
very  little  of  the  darknesa  of  the  past.  And 
if  there  may  be  still  found,  to  some  extent, 
an  apparent  unwarrantable  pride  of  country y 
growing  out  of  the  fact  that  they  have  with- 
stood, as  it  were,  every  external  influence  that 
has  been  brought  to  bear  against  them,  for 
near  two  thousand  years,  reaching  back  to 
their  first  seeking  this  safe  retreat  in  wild 
clans,  either  from  the  east  of  the  island,  or 
from  the  adjoining  continent;   circumstances 

well  calculated  to  produce  this  feeling ;   they 
9^. 


are,  on  this,  and  in  fact  every  other  acccnioty 
entirely  excusable.  In  fact,  well  may  human- 
ity and  modern  civilization  rejoice  over  this 
grand  achievement  of  such  a  race  of  men;  and 
well  may  the  English,  Scotch,  and  Irish, 
their  neighbors,  imitate  their  quiet  virtues. 

It  is  probable  that  the  superiority  of  the 
atmosphere  of  Wales,  over  that  of  England  in 
general,  may  be  allowed  as  an  offset  to  the  min- 
gling of  blood,  etc.,  in  the  case  of  the  English. 
And,  so  far  as  their  civilization  is  concerned, 
it  is  very  likely  that  the  romantic  scenery 
of  their  native  hills,  may  have  given  them 
sufficient  advantages,  to  make  up  f  >r  the  su- 
perior relations  of  their  neighbors,  the  Eng- 
lish. It  is  evident,  at  least,  that  whatever 
difference  there  may  be  between  the  English 
and  Welsh,  whichever  may  be  considered  in 
the  advance,  must  be  owing  to  the  various 
circumstances  I  have  mentiored,  as  they  were 
originally  the  same,  as  is  well-known. 

But  I  must  pass  on  to  a  consideiatiou  of  the 
''p]merald  Isle,"  and  its  inhabitants.    , 

Ireland  and  the  Irish.  . 

Ireland,  an  island  scarcely  more  Ihan  three- 
hundred  miles  in  extent  north  and  fv. uth,  aiid 


09 

little  mere  than  half  that  distance  east  and 
west,  lies  to  the  west  of  Englaad,  and  Hie 
south-west  of  Scotland,  being  boiiaded  on  the 
north,  west,  and  south  by  the  Atlantic,  and  on 
the  east  by  the  Irish  Sea  and  Chaanel,  makiog 
it  the  most  western  of  the  British  islands. 

The  northern  part  of  the  island  is  mountain- 
ous; the  central,  hilly  j  and  the  southern  quite 
level,  thus  gi'^ing  a  variety  of  surface  and  sce- 
nery. It  is  enlivened  by  numerous  rivers,  lakes, 
caverns,  etc  -Oae  of  the  most  interesting  of 
its  natural  curiosities,  is  the  Giants  Cause- 
way, at  the  north  of  the  island,  presenting 
a  very  grand  and  romantic  appearance  from 
the  ocean,  as  I  witnessed  in  passing  by;  it 
having  furnished  the  occasion  for  the  legend 
of  the  Irish  and  Scotch  giants,  made,  by  the 
fable,  inhabitants  of  these  romantic  wilds. 

Taken  as  a  whole,  Ireland  is  rather  a  rough 
appearing  country,  though  many  parts  of  the 
island  are  very  beautiful.  In  fact,  for  variety 
of  scenery,  it  is  scarcely  excelled  by  Wales  or 
Scotland ;  and  for  heauiy^  in  some  parts,  it  is 
by  no  means  itiferior  to  England.  The  &oll^ 
though  tolerably  productive,  is  by  no  means 
as  productive,  or  in  as  high  a  s^ate  of  cultiva- 
tion as  that  of  England.     It  produces,   how- 


1 00 

ever,  flax,  wheat,  oats,  rye,  barley,  potatoes, 
and  various  kinds  of  roots,  besides  tolerable 
pastures  and  meadows,  thougb  inferior  to 
those  of  England.  It  sustains,  however,  cattle, 
sheep,  horses,  donkeys,  and  other  domestic 
animals,  in  tolerable  abundance.  It  is  gener- 
ally fenced  with  hedges;  and  the  dwellings,  as 
in  England,  are  usually  of  brick  or  stone,  with 
either  tile  or  slate  roofs ;  in  some  parts,  how- 
ever, presenting,  by  no  means,  a  very  inviting 
appearance. 

The  atmosphere  of  Ireland   is  more   or  less 
damp,    like  that  of  England    and    Scotland, 
giving  a  bright  green  appearance  to  the  grain, 
grass,  and  foliage  in  general ;  and  hence  it  has 
been  very  properly  called  the  "  Emerald  Isle." 
The  hiirui'^ity  of  the   atmosrihere  of  Ireland, 
doubtless   predi.^posos    the  inhabitants,  j.s    in 
tlie  other  British  islands,  to  scrofulous,  tuber- 
calous,   and   other    kindred    affections ;    and, 
this  influence,  together  with  the  hss  sobstan- 
tJal  characfcr  of  the  f  >od,  in  8ome   localities, 
8s  well  as  the  confined  and  damp  dwellings,  in 
some    of  the  rural  distric  s,  may  very  likely 
predispose  to  typhus  and   other   putrid   fevers 
aid  disease-?;   a7?ma/-m?*«.';7?is  bcmg  added  to 
the  climatic  predispositions,  as  in   many  parts 


101 

of  England  and  Scotland,  as  we  have  seen. 
Paludal  diseases,  however,  are  scarcely  known, 
unless  imported. 

Chief  Toions. 

Ireland  lias  several  important  towns,  as 
Dublin,  Belfast,  Cork,  etc.  I  will  only  notice 
Dublin,  however,  as  the  most  important. 

Dublin,  the  principal  city  of  Ireland,  is  in 
the  eastern  part  of  the  Island,  on  the  naviga- 
ble river  Liffey,  near  the  Irish  Sea,  occupying 
a  slight  elevation,  and  being,  in  the  main,  a 
beautiful,  clean,  well-built  town.  It  is  con- 
structed mainly  of  brick. .  Some  of  the  pub- 
lic^ and  even  private  buildingS;  however,  are 
of  very  fine  stone ;  one  of  the  most  interest- 
ingly magnificent  of  which  is  Trinifi/  College. 

The  city  is  well  laid  out,  and  clemly,  being 
situated  on  bo(-.h  sides  of  the  river.  And, 
while  its  general  appearance  is  decidedly  invit- 
ing, it  has  many  structures  and  objects  of 
special  interest,  as,  the  Hoyal  Irish  Academy  ; 
ths  Museum  of  Irish  Industry;  the  Royjd 
Zoological  Gardens;  the  Botanic  Gardens; 
the  College  of  Physicians,  the  College  of 
Surgeons;  the  National  Gallery;  St,  Patrick's 
Cathedral;  the  Exhibition  Palace;  the  Castle 


102 

of  I)ul)lin;  tho  Bank  of  IrelanJ;  the  G  n- 
eral  Post  Offico;  City  Hall;  the  various  Hos- 
pitals and  Schools;  and  finally,  the  Gardens, 
Parks,  Bridges,  Fountains,  etc.,  too  numerous 
to  mention- 

Duhlin  has  2t.  population  of  near  three  hun- 
dred thousand  inhabitants;  descendants  of 
the  Irish,  Scotch,  English,  and  Welsh;  con- 
stituting the  best  looking  and  most  polite,  and 
perhaps  correct  people  of  any,  inhabiting  so 
large  a  city,  on  the  globe;  and  speaking  the 
English  language  the  most  correctly  of  any 
people  I  have  ever  met  anywhere  Such,  at 
least,  is  my  impression  of  the  Irish  of  Dub- 
lin, with  whom  I  became  more  or  less  acquaint- 
ed. I  attribute  very  much  of  this  superiority 
of  the  iohabitants  of  Dublin  to  the  mixture  of 
the  English,  Scotch,  and  Welsh  blood  and 
characters,  with  the  noble  Irish,  very  much 
as  in  the  American  character,  as  we  shall  see. 

Let  us  pass  on,  then,  to  consider  the  inhab- 
itants of  Ireland. 

The  Irish  People. 

The  first  settlers  of  Ireland  were  probably 
Carthagenians,  from  Carthage;  who  came  at 
a  very  early  period;  their  language  having 


103 


been  derived  from  the  Phcemcians,  to  whom 
the  Celts  were  probably  indebted  for  theirs. 
At  a  later  period  came  the  Iberi  from  Spain, 
with  their  Celtic  dialect,  and  mingling  their 
blood  and  language  with  the  first  Carthagenian 
settlers,  it  constituted  a  people  and  language, 
though  similar  to,  not  identical  with  the  an- 
cient Britons  and  their  language.  Hence  this 
distinction  of  the  early  Irish  character  and  lan- 
guage ;  subsequently  modified,  in  a  greater  or 
less  degree,  by  the  Roman  and  Danish  or 
Scandinavian  blood;  and  to  a  very  limited 
extent,  perhaps,  the  Saxon  and  Norman  j  in- 
fluencing or  modifying  more  or  less,  of  course, 
their  language,  as  well  as  their  physical,  in- 
tellectual, and  moral  characteristics. 

Thus,,  then,  were  I  he  original  Irish  charac- 
ter and  language  formed  ard  modified.  At 
tlie  present  time,  however,  we  find,  in  the 
large  Irish  towns,  as  in  Dublin,  a  mixture,  as 
we  have  seen,  of  the  modern  English,  Scotch, 
Vv^elsh,  and  Irish;  constituting  a  local  charac- 
ter, more  nearly  like  the  American,  made  up 
of  the  sauie  clement?!,  perhaps,  than  any  other, 
as  might  be  expected.  In  ihc  north  vf  Ire- 
land, many  Scotch  people  are  found,  having 
cmiQa'ufeod  thiihcr  froin  conH'^uou'^  parts  of 
their  nativ«  islaud. 


104 

The  Iri?li  people,  then,  being  partly  oi 
Celtic  origin,  but  modified  by  these  various 
heterogeneous  elementg,  and  so  many  external 
and  varied,  as  well  as  intrinsic  circumstances, 
present  quite  a  variety  of  characteristics, 
ranging  from  some  that  may  be  regarded,  per- 
haps, as  more  or  less  objectionable,  to  the 
most  elevated  in  the  scale  of  modern  civiliza- 
tion. 

The  scenery  and  circumstances  by  which 
the  Irish  have  been  surrounded  during  their 
transition  from  semi-barbarism  to  their  present 
state  of  civilization,  during  the  past  twenty 
centuries,  have  been  of  a  character  calculated 
to  make  just  that  kind  of  self-relying  inde- 
pendent, stubborn,  intellectual,  and  noble 
people,  with  such  varied  characteristics. 
And,  taking  the  more  mixed  Irish,  as  we 
find  them  in  Dublin,  they  surpass  in  beauty 
and  comeliness  of  person,  and  especially  the 
female  portion,  by  far  their  neighbors,  the 
English,  Scotch,  and  Welsh. 

And  it  is  very  questionable,  whether  Dub- 
lin may  not  stand  first,  among  the  cities  of 
the  British  Islands,  in  science,  literature,  arts, 
and,  in  fiict,  in  everything  pertaining  to  mod- 
ei'tt  civilization,  in  its  most  rcfiaed  sense.    At 


105 

least,  it  can  only  be  second  to  Edinburgli,  if 
to  any  of  the  British  towDS. 

While,  then,  the  atmospliere  of  all  the 
British  Islands  is  more  or  less  humid,  Ireland, 
Wales,  and  the  North  of  Scotland,  are  the 
portions  in  which  it  is  the  least  so;  England 
and  the  South  of  Scotland  being  most  damp. 
Now,  in  these  latter  portions,  the  productions 
are  the  most  abundant  and  substantial.  And 
while  the  atmosphere  of  these  parts  may  pre- 
dispose more  strongly  to  scrofulous,  tubercu- 
lous, and  kindred  affections,  the  superiority 
and  abundance  of  food  very  likely  nearly 
make  up  for  the  greater  humidity  of  the 
atmosphere.  And  as,  further,  the  superiority 
of  drainage,  ventilation,  clothing,  etc.,  in  the 
richer  and  damper  portions,  may  serve  to 
hinder  the  generation  of  as  great  an  amount 
of  animal-miasms  as  in  the  higher  and  poorer 
regions;  it  is  probable  that  the  predisposition 
to  the  diseases  common  to  the  British  Islands, 
including  scrofulous,  tuberculous,  and  other 
kindred  affections,  as  well  as  typhus,  and  other 
putrid  fevers,  may  be  more  equally  distribu- 
ted than  might,  at  first  thought,  appear. 
There  are,  however,  certain  foca?  causes  operat- 
ing to  make  endemic,  in  some  places,  ophthal- 
10 


106 

mic,  cutaneous,  and  other  dise^ges,  as  we  have 
seen. 

Such,  then,  are  the  British  Islands ;  a  mere 
speck,  as  it  were,  on  the  earth's  surface;  but 
which,  emerging  from  a  state  of  heathenish 
darkness,  as  their  inhabitants  have  during 
the  past  twenty  centuries,  have  worked  out 
the  great  problem,  that  mankind  yet  retain 
enough  of  the  '-likeness  of  the  Creator,'' 
to  enable  them,  with  the  aid  of  His  Works, 
Word,  and  the  kindly  influence  of  His  Spirit, 
to  pass  from  a  state  of  semi-barbarism  to 
a  lofty  and  enlightened  condition  of  mod- 
ern civilization  and  refinement. 

And,  if  there  may  be  found  still  to  adhere, 
now  and  then,  slight  relics  of  this  semi- 
barbarism,  to  greater  or  less  portions  of  the 
inhabitants  of  the  British  Islands,  it  has  doubt- 
less been  owing  to  circumstances  quite  beyond 
their  control  j  and  which  must  yet  surely  be 
eradicated  by  the  various  circumstances  attend- 
ing the  full  blaze  of  modern  civilization.  And 
then  may  we  hope  that  the  Anglo-Saxon 
race,  transplanted,  as  they  have  been,  to  this 
vast  continent;  and  as  they  have  b  en,  and 
may  yet  be,  to  other  parts  of  the  world  ;  may 
have  a  benign   influence  in   correcting  the  de- 


107 

fects  of  fallen  humanity,  and  in  the  elevation 
of  the  scale  of  physical,  intellectual,  and 
moral  excellence  everywhere. 

While,  then,  all  these  varied  circumstances 
have  been  thus  operating  in  the  British 
Islands  for  the  past  twenty  centuries,  working 
out  such  a  mighty  physical,  intellectual,  and 
moral  change;  who  will  dare  deny  that  all  has 
been  brought  about  and  directed  in  accordance 
with  the  eternal  purpose  of  Him  who  created 
all  things,  and  by  whom  "  they  were  and  are 
sustained/' 

France  and  the  French. 

Passing  from  the  British  Islands  south, 
over  the  English  Channel,  we  come  to  France, 
extending  to  the  Atlantic  on  the  west;  the 
Mediteranean  on  the  south,  and  the  German 
States,  Switzerland,  etc  ,  on  the  east;  embra- 
cing a  vast  area  of  country,  more  or  less  di- 
versified with  hills  and  vales,  mountains  and 
lowlands,  with  a  rich  productive  soil,  and  a 
great  variety  of  the  most  beautiful  and  roman- 
tic scenery. 

France  is  a  great  country,  with  vast  re- 
sources, having  a  variety  of  productions,  in 
great  abundance ;  among  the  most  prominent 


108 

of  whicli  are  wheat,  rye,  oats,  barley,  the 
sugar-beat,  grass,  the  yine,  and  various  deli- 
cious fruits;  including  the  apple,  peach,  pear, 
apricott,  nectarine,  plum,  cherry,  etc. 

In  fact,  France  to  me  presents  a  most  at- 
tractive appearance  in  all  its  bearings.  It  has 
a  mild  and  delightful  climate,  a  fertile  soil, 
abundant  productions,  beautiful  rivers,  an  ex- 
tensive sea-coast;  and,  in  short,  almost  every- 
thing desirable  for  the  habitation  and  comfort 
of  man.  The  farm-houses  are  generally  of 
brick  or  stone,  with  slate  roofs,  being  sur- 
rounded by  fine  flower,  kitchen  and  fruit  gar- 
dens, presenting  the  appearance  of  comfort  and 
refinement. 

The  surface  of  the  country  is  generally 
unincumbered  hy  fences ,  except  now  and  then 
a  hedge,  giving  an  extended  view  of  unbroken 
fields,  of  the  various  kinds  of  grain,  the  vine, 
etc.,  appearing  upon  the  plains  and  slightly 
rolling  grounds,  peculiarly  rich,  and  grand  in 
the  extreme.  Cattle  and  sheep,  however,  ap- 
peared to  me  not  very  abundant,  and  what  I 
did  see,  were  inferior  to  those  of  England 
and  Scotland. 

The  scenery  of  France,  then,  is  not  of  the 
wild  romantic  character  belonging  to  Wales, 


109 

Ireland,  and  Scotland,  on  the  one  hand;  nor 
of  the  placid  sentimental  kind  like  that  of 
England,  on  the  other;  being  a  medium,  as  it 
were,  between  the  two ;  affording  much  to  ex- 
cite wonder,  but  perhaps  more  to  foster  a  love 
of  the  beautiful  and  sublime. 

The  atmosphere  of  France  is  soft  and  balmy, 
like  the  American,  but  not  humid  as  in  the 
British  Islands;  and  though  the  climate  is 
somewhat  variable,  as  in  America,  it  is  not 
subject  to  very  great  extremes  of  heat  and 
cold,  making  France,  with  the  exception  of 
more  or  less  paludal  emanations,  but  slightly 
predisposed  to  any  particular  form  or  type  of 
disease,  the  French,  like  the  Americans,  being 
left,  mainly,  to  produce  their  own  diseases,  by 
various  irregularities  and  imprudences,  which 
is  also  true,  to  a  great  extent  in  the  British 
Islands,  as  in  fact,  almost  everywhere;  as  most, 
if  not  all  the  natural  predisposing,  and  even 
exciting  causes  of  disease,  everywhere,  might 
and  probably  would  be  comparatively  harmless, 
if  human  health  could  be  fortified  by  the 
effects  of  a  proper  observance  of  the  laws  of 
health,  including  all  the  principles  of  personal 
and  public  hi/giene,  as  they  should  be,  if  not 
voluntarily,  in  our  large  towns,  by  compulsory 
10* 


110 

enactments.  It  is  my  opinion,  howeverj  that 
France  is  far  in  advance,  of  any  country  with 
which  I  am  acquainted,  in  its  provisions  for 
the  enforcement  of  puhlic  hygiene.  And  I 
am  compelled  to  say,  that  I  regard  its  towns 
and  inhabitants  as  cleanly  as  any  I  have  ever 
seen.  The  natural  productions  of  France  are 
very  abundant,  however,  as  in  America,  caus- 
ing, as  with  us,  a  strong  tendency  to  irregu- 
larities and  various  excesses. 

Chief  Towns. 

France  has  many  large  towns,  by  far  the 
most  important  of  which  is  Paris,  which  as 
improved  by  Napoleon  III,  Emperor  of  the 
French,  is  now  probably  the  finest  city  in  the 
world. 

Paris  is  situated  on  the  river  Seine,  which 
divides  it,  as  the  Thames  does  London;  the 
ground  on  which  it  stands  being  slightly 
rolling,  but  rising  in  the  north  into  an  eleva- 
tion, Montmartrey  31ount  Valerian j  also,  ap- 
pearing in  the  distance  to  the  north-west, 
being  a  little  out  of  the  city. 

Thus  situated,  then,  in  the  north  of  France, 
or  north  of  its  centre,  surrounded  by  a  coun- 
iry  of  variegated  surface,  and  of  uncommoa 


Ill 

loveliness,  Paris  is  well  calculated  to  inspire 
its  inhabitants  and  the  transient  observer, 
with  a  love  of  the  beautiful  and  sublime. 

Paris  is  an  ancient  city,  having  endured  the 
shocks  of  more  than  twenty  centuries,  receiv- 
ing, now  and  then,  a  severe  check,  but  yet 
has  endured  them  all ;  having  now,  over  two 
millions  of  inhabitants;  in  1866,  2,150,916, 
mostly  French,  but  with  a  sprinkling  of 
almost  every  other  nationality. 

The  city  is  built  of  brick,  and  a  very  fine 
lightish  or  nearly  white  sand-stone,  as  I  should 
judge,  from  its  polish,  the  roofs  being  of  very 
fine  slate.  Its  streets  are  kept  exquisitely  clean, 
being  paved  with  a  compound,  which,  being 
spread  over  the  stones,  hardens,  and  makes  a 
surface  superior  to  anything  I  have  ever  seen 
for  a  street,  on  every  account.  I  suspect  that 
the  sulphate  of  lime  enters  largely  into  its 
composition,  from  what  I  saw  of  it,  in  its  soft 
and  hardened  state.  The  streets  are  gener^ 
ally  straight,  and  some  of  them  very  wide, 
giving  a  grand,  general  appearance  to  Paris, 
taken  in  connection  with  its  parks,  gardens, 
statuary,  fountains,  etc. 

The  objects  o^  special  interest,  in  and  about 
Paris,  are  the  Cath<jdral  Notre   Dame,  an  an- 


112 

cient   chapel,    occupying   the  site  of  a   still 
more  ancient  temple  of  Jupiter,  and  contain- 
ing many  sacred  relics,  among  which  is  a  part 
of  the  crown  of  thornSy  said  to  have  been  worn 
by  our  Saviour  at  the  crucifixion,  a  piece  of  the 
cross,  one  of  the  nails,  etc. ;  the  beautiful  Mada- 
line,  a  chapel  of  later  datej  the  palace  of  the 
Tuileries,  the  winter  residences  of  the  Em- 
peror; Montmartre,  the  elevation  in  the  north 
part  of  the   city,  with  its    Tower,  overlooking 
the  whole  surrounding  country;  the  Champs 
Elysees,  or  great  park,  with  the  garden  of  the 
Tuileries,   its   statuary,   fountains,   etc.;    the 
Triumphal  Arch  in  the  city  wall,  up  towards 
avenue  Neuilly;  the  Palace  of  Justice;  St.  Cha- 
pelle;  the  Palais  Royal,  the  present  residence 
of  Prince  Napoleon;  the  palace,  park,  etc.,  at 
St.  Cloud,  six  miles  down  the  Seine,  to  the  west, 
the  summer  residence  of  the  Emperor;  and, 
finally,  the  palace  of  Louis  XI Y.,  at  Versailles, 
further  down  the  Seine,  to  the  west  of  the  city, 
with  its  paintings,  fountains,  parks,  statuary, 
etc.,  of  surpassing   grandeur.     And,  besides, 
there  are  the  bridges,  gardens,  hospitals,  etc. ,  too 
numerous  to  mentioa;  the  hospitals  accommo- 
dating many  thousand  patients,   the  Lariboi- 
sierc  being,  by  far,  the  finest  I  have  ever  seen, 


113 

if  I  except,  perhaps,  tlie  new  Episcopal  hospi- 
tal of  Philadelphia. 

Paris,  then,  is  a  clean  city,  not  especially 
predisposing  its  inhabitants  to  any  particular 
forms  of  disease ;  and  being  situated  in  the 
midst  of  one  of  the  loveliest  countries  I  have 
ever  seen ;  nestling,  as  it  were,  with  gardens, 
interspersed  with  fountains,  etc.,  and  enlivened 
by  the  vast  concourse  of  residents  and  tran- 
sient visitors,  may,  perhaps,  come  as  near  il- 
lustrating the  various  refinements  of  modern 
civilization  as  any  city  on  the  globe.  And 
though  it  doubtless  has  its  dark  side,  with 
many  vices,  like  all  other  cities,  nearly  every- 
thing that  meets  the  eye  of  the  resident  or 
transient  visitor  is  calculated  to  enliven  and 
cheer,  if  not  to  refine,  the  intellectual  and 
moral  powers. 

But  I  must  hasten  on  in  conclusion  to  con- 
sider the  inhabitants  of  France. 

The  French  People. 

Descendants,  as  the  French  doubtless  are, 
of  the  same  orignal  stock,  as  the  ancient 
Greeks  and  Romans;  who,  pushing  their  emi- 
grations into  the  wilds  of  the  West  of  Europe, 
many  centuries  before  the  Christian  era,  they 


114 

evidently  constituted  a  branch  of  the  ancient 
Celtic  family;  a  people  whose  very  name  im- 
plies, as  we  have  seen,  that  they  dwelt  in  a 
covert  in  the  forest ;  thus  making  them  ori- 
ginally very  nearly  connected  with  the  in- 
habitants of  the  British  Islands,  some  of  whom 
doubtless  emigrated  from  the  North  of  France 
and  Spain ;  and,  also,  a  few  from  ancient  Car- 
thage. However  this  may  be,  the  ancient  in- 
habitants of  France  have  emerged  from  their 
original  semi-barbarous  state,  under  circum- 
stances calculated  to  make  just  such  a  refined, 
polite,  intelligent,  good-looking,  generous,  and 
noble  people,  they  now  are. 

It  should  be  remembered,  however,  that 
the  original  French  character  has  been  modi- 
fied and  doubtless  somewhat  improved  by  the 
mingling  of  the  blood,  as  well  as  the  customs, 
habits,  etc.,  of  other  surrounding  nations  or 
people,  from  the  Roman  invasion  down  to  the 
present  time. 

All  these  circumstances,  then,  together  with 
the  influence  of  climate,  soil,  productions,  and 
beauties  of  their  native  France,  have  conspired 
to  aid  these  original  semi-barbarians  to  emerge, 
during  the  past  twenty  centuries,  from  the 
darkness  of  the  past  into  a  state  of  the  most 


115 

refiaed  civilization.  And  these  circumstances 
have  doubtless  all  conspired  to  make  the  pol- 
ished peculiarity  of  their  language,  as  well  as 
the  great  personal  beauty  for  which  the 
French,  and  especially  the  females,  are  so 
justly  noted. 

It  is  probable  that  the  difference  between 
the  Normans  in  the  North  of  France,  and  the 
inhabitants  south,  along  the  Mediteranean, 
may  be  owing  in  part  to  the  difference  of 
climate ;  but  more  especially  to  the  mingling 
of  blood  in  the  case  of  the  Normans  with  the 
Danes  or  others,  who  early,  as  is  quite  prob- 
able, invaded  the  North  of  France ;  from 
whom  came  also  the  Normans,  that  in  turn 
invaded  Englaad^  modifying  so  much  the 
Anglo  Saxon  character  of  its  inhabitants,  their 
language,  etc.,  as  we  have  already  seen. 

In  the  noble  French  people,  then,  we  have 
combined  those  superior  traits  of  character 
which  constitute  the  very  highest  scale  of 
modern  civilizition  j  with  very  much  to  ad- 
mire, and  but  little  to  be  detested.  If,  how- 
ever, there  is  anything  still  adhering  to  the 
French  character  that  may  be  regarded  as  be- 
longing to  an  earlier  period  or  their  develop- 
ment, it  may  possibly  be   a  sl-'ght  inclination 


116 

to  gayety,  which  their  surroundings  might 
well  excuse,  as  being  beyond  their  control  in 
the  past,  but  which  will  doubtless  in  due  time 
become  thoroughly  eradicated  in  the  bright 
blaze  of  dawning  modern  civilization. 

Sovereigns  of  France  and  Great  Britain. 

Napoleon  III.,  Emperor  of  the  French, 
having  learned  the  stern  realities  of  life  in 
his  earlier  days,  has  been  thus  fitted  for,  and 
is  evidently  doing  much,  with  the  co  operation 
of  the  Empress,  a  lady  of  rare  attainments,  to 
elevate  France  in  the  scale  of  civilization  and 
refinement.  While  Her  Majesty,  Queen  Vic- 
toria of  England,  with  the  care  of  a  numer- 
ous family,  and  smitten  by  ihe  loss  of  her  late 
-husband.  Prince  Albert,  of  noble  memory, 
whom  she  mourns  as  none  but  woman  of  her 
greatness  and  goodness  can,  is  now  doubtless 
setting  an  example  for  her  subjects,  and  in 
fact  fur  the  world,  worthy  of  being  imitated. 

Both  sovereigns  appear  to  have  been  en- 
dowed, raised  up,  and  admirably  fitted  for  the 
responsible  positions  they  occupy;  the  various 
circumstances  surrounding  and  attending  the 
history  of  each,  having  apparently  tended  to 
the   very  desirable  result.     Such  at  least  is 


117 

the  result  of  my  observations,  and  somewhat 
mature  reflections  in  relation  to  the  sovereigns 
of  France  and  England. 

I  must  pass  on,  however,  to  a  general  glance 
at  America  and  Americans ;  closing  with  a 
few  reflections  on  the  influence  of  the  English, 
Scotch,  Welsh,  Irish,  and  French,  thus  hav- 
ing emerged  from  the  darkness  of  the  past, 
on  this  vast  continent  of  America,  scarcely 
four  hundred  years  known  to  Europeans. 

America  and  Americans, 

America,  several  thousand  miles  in  extent 
East  and  West,  lying  between  the  Atlantic 
and  Pacific  oceans;  and,  including  North,  Cen- 
tral, and  South  America,  being  many  thousand 
miles  in  extent  North  and  South ;  extending 
nearly  from  pole  to  pole;  has  every  variety  of 
climate,  from  the  cold,  dry,  bracing  atmos- 
phere of  the  British  Possessions  and  Northern 
portions  of  the  United  States  at  the  North, 
to  the  soft  and  balmy  of  the  tropical  regions 
of  Central  America;  South  America  partak- 
4ng  of  the  same  variety  of  climate,  in  a  re- 
verse order,  from  South  to  North,  modified  of 
course  by  various  local  influences. 

Except  the  ridge  of  mountains,  called  the 
11 


118 

Rocky^  extending  along  the  western  part  of 
North,  and  the  Ande^  of  South  America ; 
nearly  this  whole  extent  of  country,  including 
North,  Central,  and  South  America,  is  rich 
and  fertile  )  abounding  in  lakes,  rivers,  prai- 
ries, rolling  ground,  hills,  and  vales;  embrac- 
ing an  endless  variety  of  grand,  beautiful, 
and  romantic  scenery;  and  producing  wheat, 
corn,  rye,  oats,  barley,  peas,  beans,  roots,  sugar- 
cane, rice,  cotton,  coffee,  etc.,  also  that  curse 
to  the  soil  and  people,  tobacco;  as  well  as  the 
fruits;  as  apples,  peaches,  pears,  plums,  apri- 
cots, nectarines,  the  vine,  and  various  tropical 
fruits  in  great  abundance.  It  is  hardly  neces- 
sary to  add,  that  with  such  a  variety  of  cli- 
mate, soil,  and  productions,  almost  every  vari- 
ety and  species  of  useful  domestic  animals  are 
found  in  abundance. 

Chief  Towns. 

I  will  only  say,  in  relation  to  the  chief 
towns  in  America,  that  while  immense  inland 
cities  are  found  in  almost  every  direction  and 
section  of  the  country,  they  are  perhaps  more 
numerous  along  and  near  the  Pacific  and  At- 
lantic coasts,  all  comparing  favorably  with  the 
older  cities  of  the  British  Islands  and  France. 


119 

New  York  and  Philadelphia^  scarcely  ninety 
miles  apart,  approximate,  and  will  doubtless 
very  soon  reach  a  million  of  inhabitants  each. 
And  while  Philadelphia  is  very  pleasantly  sit- 
uated between  the  Delaware  and  Schuylkill, 
with  scarcely  no  natural  predisposing  causes 
of  disease  to  annoy  its  inhabitants,  New  York, 
scarcely  less  favorably  located  in  this  respect, 
is,  on  all  accounts,  one  of  the  finest  commer- 
cial cities  in  the  world.  With  the  enforce- 
ment of  proper  hygienic  and  sanitary  regula- 
tions, including  quarantine.  New  York  and 
Philadelphia,  as  well  as  most  of  the  Ameri- 
can cities,  might  become  the  most  healthy  in 
the  world. 

The  American  People. 

While  the  American  character  is  young  as 
yet,  being  scarcely  four  hundred  years  old,  it 
has  originated  in  a  greater  mingling  of  noble 
blood,  and  of  varied  national  characteristics 
than  any  other  since  the  creation  of  Adam, 
constituting  a  noble,  generous,  intelligent, 
industrious,  progressive  people. 

No  sooner  had  the  Anglo-Saxon  and  French 
people  reached  a  condition  in  which  they  might 
be  regarded  as  able  to  colonize  the  neio  world, 
than  the  discovery  of  America  by  Columbus, 


120 

a  Spaniard  of  the  same  original  Celtic  stock, 
opened  the  way;  South  and  Central  America 
having  been  settled  mainly  by  his  own  peo- 
ple, the  Spaniards ;  while  North  America  was 
colonized  mostly  by  the  Anglo-Saxons  and 
French;  Canada,  Louisiana^  and  many  parts 
of  the  United  States,  having  been  originally 
settled  by  the  French;  while  the  English, 
Scotch,  Welsh,  Irish,  etc.,  were  the  principal 
settlers  of  the  United  States  of  America; 
giving  the  English  language  the  ascendency; 
and  by  conq-uest  and  purchase,  finally  making 
the  Anglo-Saxon  race  the  rulers  of  nearly  all 
of  North  America. 

American  Governments  and  Civilization. 

Americans  of  Spanish  descent  hold  most  of 
Central  and  South  America ;  Canada  still  ad- 
hering to  the  British  crown;  the  United 
States  constituting  an  independent  federal  re- 
public; while  Mexico,  Central  and  South 
America^  except  the  Empire  of  Brazil,  are  un- 
der various  republican  forms  of  government.* 

In  a  country,  then,  like  America,  of  such 
vast  dimensions,  extending  from  ocean  to 
ocean,  and  from  sea  to  sea;  having  such  a 

*  Grreenland  bclougs  to  Demuurk. 


121 

variety  of  scenery,  climate,  soil,  and  produc- 
tions, well  might  Eastern  civilization  take 
root,  spring  forth,  and  flourish  with  great  lux- 
uriance; and  especially  so,  as  the  still  greater 
mingling  of  blood,  as  well  as  of  the  manners, 
customs,  etc.,  of  these  different  nationalities 
and  races  of  men  from  the  old  world,  must 
necessarily,  as  we  have  seen  in  Europe,  form 
in  the  American  people  a  new  national  char- 
acter, improved  physically,  intellectually,  and 
morally;  requiring,  however,  the  politeness, 
stability,  and  refinements  of  more  mature  age 
for  its  perfection. 

Conclusion. 

Thus,  then,  has  the  combined  civilization 
that  we  have  been  tracing  in  the  British 
Islands  and  France  during  the  past  twenty 
centuries,  been  transplanted,  with  our  ances- 
tors, from  its  original  soil  to  this  vast  conti- 
nent of  America,  being  shorn  of  many  of  its 
defects  by  circumstances  that  have  been  trans- 
piring, forming  a  new  national  character^  in 
which  should  be  retained  the  excellencies  of 
the  trans-Atlantic  parent;  which,  being  nur- 
tured and  perfected  by  the  influence  of  gen- 
eral iutelligcncc  and  republican  institutions, 


122 

with  civil  and  religious  liberty,  may  be  the 
dawning  of  a  new  era  in  the  world's  history, 
in  which  justice,  equity,  mercy,  and  all  the 
noble  attributes  of  primitive  civilization  or 
excellence  shall  be  revived,  ultimately  leading 
on  to  a  recognition  of  the  universal  brother- 
hood of  man,  causing  the  beauties  of  Eden 
to  again  grace  the  world,  as  mankind  shall 
approximate  their  primitive  state  of  physical, 
intellectual,  and  moral  excellence.  And  as 
very  much  of  our  physical,  as  well  as  intellec- 
tual and  moral  imperfection,  is  self-inflicted,  as 
we  have  seen ;  resulting  from  the  various  de- 
viations from  the  laws  of  our  being,  physical, 
intellectual,  and  moral;  it  only  remains  for 
us,  as  individuals  and  nations,  to  improve  in 
the  future  from  the  experience  of  the  past, 
as  well  as  by  all  the  surrounding  transpiring 
circumstances;  following  intently  and  admir- 
ingly the  teachings  of  the  Works  and  Word 
of  God,  as  well  as  heeding  the  kindly  influ- 
ence of  His  Spirit,  to  thus  complete  that 
which  has  been  so  nobly  begun  in  the  British 
Islands,  France,  and  America,  and,  in  fact,  the 
whole  civilized  world,  where  the  dawning  light 
of  modern  Christian  civilization  is  beginning  to 
display  its  benign  and  imperishable  splendorw. 


MAXSON'S  PRACTICE  OF  MEDICINE. 

BY  EDWIN  R.  MAXSON,  M.D., 

Formerly  Lecturer  on  the  Institutes  and  Practice  of  Medicine 
in  the  Geneva  Medical  College,  N.  Y,,  &c.,  Ac. 

In  one  volume,  705  royal  octavo  pages.     Price 
$4.00.     Sent  by  mail,  free  of  postage^  upon 
receipt  of  this  amount. 
Published  by 

LINDSAY  &  BLAKISTON, 

Philadelphia. 


This  valuable  test-book  on  the  Practice  of 
Medicine  has  not  become  as  well  known  as  its 
merits  deserve.  The  following  notices  from  the 
Medical  Press  indicate  its  value. 

"Brief,  yet  comprehensive  and  well  arranged; 
just  such  a  book  as  a  student  requires." — S. 
H.  Dickson,  M,D.,LL.D,,  Prof  of  Princijjles 
and  Practice  of  Medicine,  Jefferson  Medical 
College,  Philadelphia. 

"  This  volume  contains  a  compendious  view  of 
the  whole  field  of  medicine,  including  pathol- 


ogy  and  therapeutics,  with  a  glance  at  anatomy 
and  physiology." — North  American  Med.  and 
Chirurg.  Bevieiv. 

."The  work  gives  the  most  recent  therapeutics, 
and  those  who  are  in  the  habit  of  using  the 
new  and  the-  concentrated  remedies  will  appre- 
ciate the  volume/' — Medical  and  Surgical  Re- 
porter. 

""We  commend  the  whole  subject  matter  of  Dr. 
Maxson's  book  to  favorable  notice." — Ameri- 
can Medical  Monthly. 

"Let  us  advise  the  practitioner  and  student  to 
add  this  volume  to  their  collection,  as  we  think 
it  will  be  read  with  increasing  interest  and 
undoubted  advantage. '' — Cincinnati  Medical 
and  Surgical  News. 

"It  is  handsomely  printed  with  clear  iype^  on 
good  paper,  and  we  hope  it  may  soon  be  found 
in  the  library  of  every  practitioner  of  medi- 
cine."— Journal  of  Materia  Medica. 

"The  author's  reasoning  is  good  wherever  he 
attempts  it,  and  his  practice  is  equally  good 
wherever  he  recommends  it." — British  Ameri- 
can Journal. 


UNIVERSITY  OF  CALIFORNIA  LIBRARY 

Los  Angdes 
This  book  is  DUE  on  the  last  date  stamped  below. 


[     2  1960 

BIOMEO  UB. 
M(\^  2  3  RtC'D 

BIOMED    MAY  06 

MAY  0  6 1988 


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